Reactive Arthritis

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Reactive arthritis refers to pain, stiffness, redness or swelling in a joint resulting from a previous infection. It most often occurs in the joints of the lower limbs (knees, ankles, toes), but can also occur in the upper limbs. Problems may be in the joints only or involve other body systems such as the eyes, skin muscles or tendons.

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Establishing the correct diagnosis is important, so if your doctor thinks you have reactive arthritis, he or she may ask questions about the symptoms, other medical conditions, recent travel, illnesses, and contact with people who may have had infections. Because there is a usually a lag time of several days to weeks between the infection that is the underlying cause of the arthritis and the onset of inflammation, a person might not connect the two events and so not think of mentioning the previous infection. Your doctor may also perform a physical examination, and order x-rays and other tests to find out what has caused the arthritis.

Diagnosis may be difficult as there is no specific test that confirms reactive arthritis is present. Your doctor will probably perform a physical examination and order other tests such as x-rays and blood tests. One test called an ESR (erythrocyte sedimentation rate) measures the level of red blood cells that are settling in the muscle. The erythrocyte sedimentation rate (ESR) is often high in people with reactive arthritis. If you have reactive arthritis you may also have anaemia. This is a condition of the blood that can cause you to look pale, and feel weak, sleepy and dizzy.

Other tests your doctor may perform include tests of your stool (feces), or the fluids and tissues of your urethra or joints. About half of patients with reactive arthritis have a positive HLA-B27 test. This suggests a genetic predisposition to reactive arthritis but it is not always an indication of the disease.

In many cases reactive arthritis goes away on its own within a few days or a few weeks. Some cases may take up to four months before they completely resolve. Other people have recurrent attacks. However, given treatment most people with reactive arthritis manage well. Your active involvement in developing your treatment plan is essential.

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