Overview of Reactive Arthritis

Reactive arthritis (ReA) is a form of arthritis that can cause inflammation and pain in the joints, skin, eyes, bladder, genitals, and mucus membranes. Unlike ankylosing spondylitis, ReA does not normally affect the spine and the sacroiliac joints in a majority of cases. ReA is thought to occur as a "reaction" to an infection that started elsewhere in the body, generally in the genitourinary or gastrointestinal tract.

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Potential Causes of Reactive Arthritis

Reactive arthritis occurs after exposure to or infection caused by certain types of bacteria. These include:

  • Chlamydia, a bacterium contracted during sexual activity, which causes either burning during urination or watery discharge from the penis or vagina.
  • Bacteria such as Salmonella, Shigella, Yersinia or Campylobacter, which cause dysentery (diarrhea, abdominal pain, vomiting, fever). Exposure to these bacteria occurs after eating spoiled or contaminated food.

No everyone exposed to these bacteria, however, will contract ReA. Those who go on to develop ReA are more likely to test positive for the HLA-B27 genetic marker, although other genetic factors may be involved. Thus, it is an interaction between an individual's genetic make-up and the initial infection that causes reactive arthritis.

Disease Course/Prognosis

Reactive arthritis usually develops two to four weeks after infection and typically follows a limited course, with most people recovering from its symptoms in three to 12 months. 

A tendency does exist for more severe and long-term disease in patients who test positive for HLA-B27, as well as in those who have a family history of spondyloarthritis.

In about 15 to 20 percent of people with ReA, the condition recurs, sometimes brought on by reinfection. There is also a possibility of developing a chronic form of arthritis. Though the chronic arthritis brought on by ReA is usually mild, a minority of people develop a more severe form of arthritis, or spondyloarthritis.

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