Reactive arthritis

(BMJ module on STIs)

My name is (almost) a disease, it seems. Reactive arthritis is a sterile arthritis triggered by an infection elsewhere, typically urogenital or gastrointestinal, and SARA stands for sexually acquired reactive arthritis, most often triggered by chlamydia.

Reactive arthritis usually shows up 2 – 4 weeks after the triggering infection. Other symptoms associated with reactive arthritis include:

  • Urethritis (not surprisingly)
  • Conjunctivitis (the combination of urethritis, arthritis and conjunctivitis used to be referred to as Reiter’s syndrome, but the term has now been dropped)
  • Uveitis
  • Circinate balanitis or vulvitis – shallow painless ulcers
  • Mouth ulcers
  • Skin reactions, such as keratoderma blennorrhagica (say what now?)
  • Cardiac, renal, or neurological involvement

It normally resolves in 3 – 12 months, but the course is variable and around 15 – 20% will develop chronic disabling symptoms (e.g. arthritis or eye inflammation).

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About Dr Sarah

I'm a GP with a husband and two young children.
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