Reactive arthritis: symptoms and treatment

Reactive arthritis: symptoms and treatment

The term "reactive arthritis" refers to a group of inflammatory non-plague joint diseases that develop within 30 days after an infection (usually intestinal or urinary tract infection, as well as viral hepatitis, HIV and some others).

This pathology develops mainly in persons who have a genetic predisposition to it. You can get sick with reactive arthritis at any age, but they are more often affected by men aged 20-40 years. The incidence of the disease varies from 0.

2 to 12% of all cases of intestinal and urogenital infections.

About why reactive arthritis develops, and with what symptoms it proceeds, and also about principles of diagnostics and tactics of treatment of this pathology, you will learn from our article.

Causes

In most cases, reactive arthritis develops shortly after an intestinal or urogenital infection.

As it was said above, the leading causes of reactive arthritis are genetic predisposition and transferred intestinal, urogenital or other infection.

The essence of the genetic predisposition lies in the carriage of a certain histocompatibility gene - HLA-B27 (it is found in 3-4 out of 5 persons suffering from this disease).

Probably, there are other factors that influence the development of this pathology - this issue is still being studied by scientists.

Types of reactive arthritis

Depending on the causative factor (the transferred infection) allocate:

• arthritis associated with urinary tract infection;
• arthritis associated with intestinal infection;
• Arthritis associated with viral hepatitis, HIV or other viral infection;
• Arthritis arising from transferred pharyngitis or tonsillitis.

By the nature of the course, these forms of reactive arthritis are distinguished:

1. acute (the disease lasts less than six months);
2. prolonged (symptoms are determined within 6-12 months);
3. chronic (lasts more than a year);
4. recurrent (after a seemingly complete recovery symptoms arise again and again).

Symptoms, peculiarities of the course

Reactive arthritis is characterized by a complex of the most diverse clinical manifestations, reflecting not only joint damage, but also the involvement of a number of other organs and systems in the pathological process.

And the symptoms of this pathology occur when the signs of a provoking infection have completely regressed - a person has recovered, and maybe completely forgot about the recent infectious disease.

As is typical, arthritis is usually caused by mild infections, even if they are worn out or completely asymptomatic.

Common symptoms:

• increase in body temperature (more often - to subfebrile (37.0-37.6 ° C), less often - to febrile (38.0-38.9 ° C) and higher values);
• weakness, fatigue;
• decreased appetite;
• decrease in body weight (this symptom is determined in 1 out of 10 patients).

Symptoms of joint damage:

1. suffer mainly joints of the lower extremities (they are edematic, hyperemic (reddened), painful, their function is broken);
2. arthritis is asymmetrical (for example, signs of inflammation of the left ankle and right knee joints can be determined);
3. joints and other parts of the body may be affected, but the joints of the legs are involved in the pathological process necessarily, and in general the number of inflamed joints is not more than 6.

Other symptoms:

• inflammation of the tendons and ligaments in the places where they attach to the bones (more often - in the region of the heels and separate toes of the foot (manifested by swelling, intense pain in the finger, cyanotic coloring));
• non-infectious inflammation of mucous membranes - oral cavity, conjunctiva, genital organs;
• hyperkeratosis of the palms, soles, less often - of other parts of the body (keratoderma);
• yellowing, fracture and other symptoms of nail damage.

Clinical manifestations of internal organs:

Principles of diagnostics

The doctor will listen to complaints and anamnesis of the disease, carefully examine the patient, and after - appoint him laboratory and instrumental methods of research.

Taking into account the data of each stage of the survey, the final diagnosis will be made.

When a patient with symptoms of reactive arthritis turns to a doctor, a specialist:

1. he listens to his complaints;
2. in detail will study the anamnesis of a life and disease (will estimate or appreciate communication with the infection transferred earlier);
3. will conduct an objective examination (examination, palpation, percussion and auscultation - to assess how an internal organ functions);
4. on the basis of the data obtained, he will make a preliminary diagnosis of "reactive arthritis".

To confirm this diagnosis, the doctor will assign a number of laboratory and instrumental methods of investigation to the patient. Also, the examination will help to exclude other similar in course with reactive arthritis disease, identify complications, evaluate the effectiveness of treatment of an arthritis-provoking infection.

The patient will be recommended such laboratory studies:

• clinical blood test (a moderate increase in the number of leukocytes and platelets, a decrease in red blood cells and hemoglobin (anemia), increased ESR, C-reactive protein, IgA level);
• general analysis of urine (with urethritis, an increased level of leukocytes, with glomerulonephritis - protein and erythrocytes);
• biochemical blood test (ALT, ASAT, alkaline phosphatase will help to assess whether the liver functions normally; Creatinine and urea will tell you about the work of the kidneys; The level of uric acid will exclude or confirm gout in patient);
• search for HLA-B27 antigen (found in 3-4 of 5 patients with this pathology, in genetically predisposed individuals, reactive arthritis occurs, as a rule, hard, often chronic);
• study markers of acute viral hepatitis and HIV (in the latter, reactive arthritis is characterized by a particularly severe course);
• Research to find a disease-provoking microorganism (sowing stools or scrapes from inflamed mucous membranes);
• study of synovial (intra-articular) fluid (it will be found nonspecific inflammatory changes (leukocytosis with neutrophilia, low viscosity and others)).

Of the instrumental studies, the most important is the radiography of the affected joints. Also, patients are prescribed electrocardiography, ultrasound of the heart and other diagnostic methods, depending on previously identified or suspected changes in internal organs associated with reactive arthritis.

On the roentgenogram of the affected joint, you can find:

1. signs of soft tissue edema around the joint itself;
2. with prolonged / chronic course of the pathological process - osteoporosis, erosion and subchondral sclerosis in the area of ​​the affected tendon, signs inflammation of the periosteum, unilateral sakroileitis (lesion of the sacroiliac joint), extremely rarely - signs of spinal cord injury - spondylitis;
3. in chronic forms - narrowing of the joint gap, bone erosion in the area of ​​small joints of the feet.

If necessary, the rheumatologist will recommend to the patient the consultations of specialized specialists - gynecologist, urologist, ophthalmologist and others.

Diagnostic criteria

There are no generally accepted criteria for the diagnosis of reactive arthritis.

In 1995, the German Rheumatology Society proposed the following criteria:

1. Characteristic for reactive arthritis joint damage (mainly large joints of the lower extremities, asymmetry).
2. Postponed no later than a month ago infectious disease (more often - intestinal or urogenital infection).
3. Detection of the pathogen (for example, in a scraping from the urethra).
4. Detection of high titres of antibodies to certain microorganisms in the blood (for example, to causative agents of intestinal infections).
5. Detection of the histocompatibility antigen HLA-B27.
6. Detection of pathogen by polymerase chain reaction (PCR).

If the patient has criteria 1 + 3, or 4, or 6, the diagnosis of "reactive arthritis" is considered reliable.

In the presence of criteria 1 + 2 and / or 5 diagnosis is possible.

If there is only criterion 1, reactive arthritis is considered possible.

Russian rheumatologists also developed a draft criteria, according to which the criteria are divided into "large" and "small".

The "big" criteria are as follows:

1. The patient has arthritis (the joints of the lower extremities are affected, the total number of affected joints is no more than 6, arthritis is asymmetric).
2. Anamnestic data indicate a transferred infection (intestinal (enteritis) - up to 6 weeks before the appearance symptoms of arthritis or urogenital (cervicitis / urethritis) - for up to 2 months before the onset of symptoms of defeat joints).

"Small" criterion 1. Its essence lies in the laboratory verification of the causative agent of the infection, which provoked the development of arthritis (more often it is Chlamydia, Yersinia, Salmonella, Shigella, Campylobacter).

If the patient has all 3 criteria - 2 large and 1 small, the diagnosis "reactive arthritis" is regarded as definite, not causing doubt.

In the case where there are only 2 "large" criteria or 1 "large" and 1 "small the diagnosis of "reactive arthritis" is considered probable.

Differential diagnostics

Some diseases occur with symptoms similar to those of reactive arthritis. Of course, they need to be able to be distinguished from each other, because an incorrect diagnosis will entail wrong treatment - the patient's condition will not improve it exactly.

So, when suspicion of reactive arthritis should be carried out differential diagnosis of such diseases:

Treatment

The main areas of treatment are antimicrobial and anti-inflammatory therapy.

At the stage of specification of the diagnosis and selection of therapy the patient is hospitalized in the hospital of the rheumatology department.

The goal of the treatment is to eliminate the arthritis-provoking infection, to achieve remission of reactive arthritis, or to completely relieve the patient of this pathology.

Treatment in the vast majority of cases is medicated.

There is no single therapy scheme, the doctor prescribes it strictly with an individual approach, because the causative factor of arthritis (infection) can be different, and the nature of the course of the disease also varies - in each patient it flows with its own features.

Patients may be assigned:

• antimicrobials (antibiotics, to which the detected microorganism is sensitive, until the infection is completely eliminated, with microbiological control upon completion of the course of treatment; if there is a urogenital infection, it is necessary to treat not only the patient with reactive arthritis, but also his sexual partner);
• non-steroidal anti-inflammatory drugs (diclofenac, meloxicam, rofecoxib and others; drug choice is based on patient's tolerability and individual sensitivity to a particular drug means);
• corticosteroids (in most cases they are used topically - by injection into the affected joint or the area of ​​the inflamed tendon, in the form of ocular drops - with conjunctivitis; in severe cases of the disease, proceeding with the defeat of internal organs, it is possible to take hormones inside, but short course);
• cytostatics (sulfasalazine, azathioprine, methotrexate and others, applied in the absence of the effect of treatment for 3 months, have a powerful anti-inflammatory effect, but large-scale placebo-controlled studies of the efficacy of these drugs in reactive arthritis have not yet was conducted).

Forecast

The disease can proceed in many ways. In most cases (up to 80-90%) it is characterized by a benign course and ends with complete recovery in 4-6-12 months.

Can recur - every second patient suffers from reactive arthritis repeatedly.

Sometimes the pathology is chronic - the symptoms of it in such patients persist for 12 months or more.

Conclusion

Reactive arthritis is an inflammation of the joints, which develops soon after the infection, usually when its symptoms are completely absent.

In most cases, it develops in genetically predisposed individuals (they have histocompatibility antigens HLA-B27).

It is characterized by the defeat of the joints of predominantly lower extremities, asymmetric, non-swollen character, as well as tendinitis, myositis, skin symptoms, and in severe cases and systemic manifestations.

The diagnosis is based on clinical (arthritis of the joints of the lower limbs), anamnestic (transferred shortly before the intestinal, urogenital or (rarely) other infection) of the data in combination with the results of laboratory methods of investigation (detection of the pathogen and HLA-B27).

The basis of treatment is antimicrobial and anti-inflammatory drugs, in severe cases, cytostatics are added to it.

The prognosis, as a rule, is favorable - in 4 out of 5 patients reactive arthritis within half a year ends with complete recovery.

That's why if you have symptoms similar to manifestations of reactive arthritis, please do not self-medicate, but seek help from a doctor.

To which doctor to apply

When inflammation of the joints, you must consult a therapist or rheumatologist.

If you suspect a reactive arthritis, you may need to consult a urologist, gynecologist, ophthalmologist, hepatologist, infectious disease specialist, cardiologist, nephrologist or neurologist, depending on the alleged cause of the lesion joints.

A source: https://myfamilydoctor.ru/reaktivnyj-artrit-simptomy-i-lechenie/

Reactive arthritis - symptoms and treatment

Reactive arthritis (ReA) is an inflammatory lesion of the joints, which occurs as a reaction to the invasion of any infectious agents.

It is important to note that the joint cavity retains its sterility (that is, the inflammation is aseptic).

Deep causes of ReA still remain uncovered. It is believed that the infection plays the role of a trigger, which in the presence of a genetic predisposition triggers an immunopathological reaction.

Causes of the disease

This disease can be triggered by various bacterial infectious diseases, often infections of the gastrointestinal tract and the genitourinary system.

In reactive arthritis, which is triggered by an infection of the genitourinary system, the initial factor is infection in the urethra, bladder and genital organs.

In the case of an infection associated with food poisoning, a condition called enteroarthritis occurs.

One to two percent of people who have been poisoned with food, suffer from the development of the inflammatory process of the joints a few weeks after poisoning.

A certain role is played by the hereditary predisposition, many people suffering from reactive arthritis have the HLA-B27 gene.

What causes the ailment?

As already mentioned, reactive arthritis is a partially genetically determined disease.

There are certain genetic markers that occur much more often in patients with reactive arthritis than those who have never suffered from the disease.

For example, patients with reactive arthritis often have HLA-B27 gene. But even in patients with a genetic predisposition, reactive arthritis develops only in the case of infection.

Reactive arthritis can occur after venereal infections. The most common bacterium that has been associated with this post-venereal form of reactive arthritis is a chlamydial infection.

It also occurs after infectious dysentery, when infected with bacteria such as Salmonella, Shigella, Yersinia, Campylobacter.

As a rule, arthritis develops one to three weeks after the onset of bacterial infection.

Risk factors

Reactive arthritis most often affects people aged 20-40 years.

Interestingly, after sexually transmitted infections, men are nine times more likely to get sick than women, while after intestinal infections the risk is the same.

Men are slightly heavier than women. The risk is elevated in individuals who have HLA B 27, but his research before the development of the disease is not necessary.

Reactive arthritis in children

More rarely, but still there is reactive arthritis in children. The disease is no less serious than that of adults, and can significantly affect the child's future life, especially if it is a sporting future.

Symptomatic in childhood depends on the type of arthritis, age. But the main symptoms can be identified as follows:

1. Before the direct manifestation of symptoms of arthritis, the child's fever, diarrhea, often runs to the toilet on a small. The same signs can also speak of an intestinal infection (dysentery, salmonellosis) or of problems of an infectious nature in the genitourinary system (urethritis, cystitis, chlamydia).
2. With reactive arthritis in children, mainly the joints of the legs - ankle, hip or knee joint - inflame. The joints increase noticeably in size.
3. With active physical exertion, severe pain is felt.
4. Drowsiness, weakness.
5. Inflammation of the eyes, tearing, fear of bright light.

If the disease is diagnosed in time, the results of treatment will be positive, getting rid of reactive arthritis will pass quickly enough.

In addition to antibiotics, anti-inflammatory drugs, immunomodulating drugs, very effective is exercise therapy, other health procedures.

Symptoms of reactive arthritis

In the first two - four weeks, the patient has an intestinal disorder, acute respiratory disease, or an ailment very similar to cystitis in the initial stage.

Further, the symptoms of reactive arthritis become classical and conditionally divided into three groups:

• inflammation of the mucous membranes of the eyes (develops conjunctivitis) and the eyes themselves;
• there are painful sensations in the joints (their activity is limited, redness and swelling appear);
• develop inflammation in the genitourinary sphere.

In most cases, the initial inflammation occurs in one joint, and only then the disease affects whole articular groups. Clinical manifestations of reactive arthritis range from transient monoarthritis to a fairly severe multi-systemic disease.

There may be polyarthritis or asymmetric oligoarthritis, which mainly affects the toes or large joints of the lower limbs. In severe disease, pain in the back is possible.

How to diagnose?

In order to understand how to treat reactive arthritis, you must first diagnose it correctly. From the accuracy and timeliness of the diagnosis, the success of all subsequent treatment will depend a lot.

In the photo, you can view the external symptoms of the disease, but otherwise you should consult a doctor if you have the following complaints:

• pain in the joints;
• the presence of any characteristic infection, which manifested itself a few weeks before the problems with joints;
• the problem arises in no more than 4 to 5 joints at a time;
• marked asymmetry in problems with joints;
• most problems with leg joints.

Symptoms are sometimes deceptive and similar to other diseases and therefore it is important for a specialist to apply differential diagnosis.

Prevention

Prophylaxis of reactive arthritis is reduced to the prevention of infectious diseases: hygienic procedures, proper preparation of food, observance of the shelf life of food.

When diseases occur, adequate treatment is necessary, appointed by a specialist. During the next 1-3 weeks, it is necessary to observe the protective regime and avoid re-infection.

Treatment of reactive arthritis

In the case of diagnosed reactive arthritis, treatment should be carried out by rheumatologists. With its parallel development with acute infectious disease, the treating specialist can become an infectious disease doctor.

Medicamental treatment can be divided into several main areas:

• elimination of the inflammatory process;
• therapy of intestinal or respiratory infection;
• therapy of chlamydia;
• therapy for conjunctivitis in Reiter's syndrome.

Anesthetics are also prescribed to relieve joint pain, and in severe cases, glucocorticoids and immunosuppressors.

Treatment of this ailment is carried out on an outpatient basis, hospitalization is carried out only in cases when the diagnosis is unclear and constant monitoring is required, as well as with very pronounced manifestations of the disease and a general severe condition.

Prognosis of the disease

For patients who underwent complex treatment for reactive arthritis, there is the following prognosis for further life:

1. In 20% of cases, the symptoms disappear within 6 months;
2. After properly selected treatment there is no recurrence of the disease;
3. In 25% of cases, reactive arthritis passes into the chronic stage, progressing only in the phase of exacerbation;
4. In 50% of cases, the disease after a certain period of time begins to progress with renewed vigor;

Only in 5% of cases the severe form of reactive arthritis leads to deformation of the spine and joints.

Diet

It is important to follow a diet. The diet should include natural omega-3 fatty acids, which are rich in sea fish and linseed oil. The diet should not contain exciting, overly sharp and salty foods.

It is noticed that some vegetables of the Solanaceae family can cause an aggravation of the disease and intensify the symptoms of reactive arthritis.

Therefore, use potatoes, tomatoes, eggplant and sweet peppers with caution.

A source: http://simptomy-lechenie.net/reaktivnyj-artrit-simptomy-i-lechenie/

Reactive arthritis: symptoms, treatment, diagnosis

With symptoms of reactive arthritis, it is necessary to quickly diagnose this ailment and immediately prescribe treatment. Experts estimate reactive arthritis as not the most serious, but often occurring disease of articular tissues.

There are many types of disease and each has its own characteristics of manifestation and treatment, so it is important to promptly identify the cause of the pathology and treat reactive arthritis, based on its origin.

Mechanism of defeat

In fact, the disease is an inflammatory process caused by the activity of the body's own immune mechanisms. Articular tissues are affected by antibodies that begin to attack cells of connective tissue.

Such antibodies are not found in healthy organisms, they arise against the background of diseases caused by infectious agents. In some pathologies, the risks of developing arthritis are quite high.

The connection of infectious pathogens with cells is caused by the fact that in the structure of microorganisms and in human cells there are protein-like components similar in structure (this phenomenon has a separate name - molecular mimicry).

Immunity due to these proteins reveals the microbe and makes attacks on it. Therefore, articular cells can undergo erroneous attacks due to the similarity of protein structures. Reactive protein is one of the important indicators of the presence of the disease.

In addition, experts believe that genetic predisposition plays an important role in this process. There are a number of data confirming that in the presence of a specific gene, the risk of arthritis after infection is much higher.

If small joints are more often affected in rheumatoid arthritis, reactive pathology affects large joints. The disease progresses when the following systemic diseases affect the cartilage tissue:

• syringomyelia - pathology of the spinal cord;
• leukemia;
• diseases of the endocrine system;
• dystrophic pathologies - they are more often diagnosed in the elderly due to age-related changes;
• ailments, accompanied by a violation of calcium metabolism in the body, this can be the cause of subsidence of salts on cartilage tissues (the most common form disease); in this case pyrophosphate arthropathy develops, which can occur due to injuries of the hip, elbow, knee joints, infections, hypocalcemia.
• ideopathic form - in this case, experts can not figure out what exactly caused the pathological changes.

In addition, there is a form of psoriatic arthropathy - a form of hereditary pathology, transmitted by genetic means. Such reactive arthropathy in children is manifested at a very early age.

What causes pathology?

There are several classifications of the disease, one of which is based on the causes of reactive arthritis:

1. Viruses. Today, more than 30 pathogens of this type have been identified, capable of provoking the development of joint disease. Viral arthritis can occur on a background of rubella, hepatitis type B, herpetic infection, enterovirus, etc.
2. Streptococci. They are the cause of post-streptococcal arthritis. In most cases, the disease is accompanied by infectious ailments of the nasopharynx caused by streptococci, which is present in the healthy microflora of the body. The causative agent causes the following diseases: acute tonsillitis, pharyngitis, scarlet fever, inflammation of the bronchi, lungs and other pathological conditions.
3. Staphylococci. Another causative agent that can cause arthritis. Against the background of staphylococcal infections develops septic type of disease.
4. Mycobacterium tuberculosis (Koch's stick). In this case we are talking about tuberculosis arthritis, which arises from the extrapulmonary form of tuberculosis.
5. Gonococci. The occurrence of gonococcal arthritis is associated with an asymptomatic course of gonorrhea or gonococcal infections developing in the pharynx or intestine.
6. Spirochetes.

Chronic migratory erythema or Lyme disease is an ailment that affects many body systems, including the musculoskeletal system. This pathology often turns into a chronic stage and is prone to recurrence.

In addition, there is a generalized division of the disease into:

• urogenic reactive arthritis - associated with diseases of the genitourinary system;
• postterocerotic reactive arthritis - develops against the background of infections of the gastrointestinal tract, is more often diagnosed in men.

Children can also develop reactive arthritis, the reasons are due to the fact that with frequent illnesses there is a weakening of immunity, and it is not difficult for pathogens to penetrate into tissues and system.

The most common pathogens in this case are chlamydia or bacteria that cause enterocolitis.

In this case, reactive arthritis of the hip joint can develop, which affects children under 14 years old and young people under 30 years old.

Classification of the disease according to ICD-10

If we consider the classification of the disease according to the ICD - 10, the main types of reactive arthritis are the following:

• arthropathy - secondary lesions of the joint tissues, which develop against the background of other diseases and pathologies:
• arthropathy accompanying intestinal bypass;
• postdisenteric lesion is a pathology in which changes concern both connective tissues and musculoskeletal;
• postimunizatsionnoe defeat - the ailment affects the muscles and bones; associated with recent immunization;
• Reiter's disease - additionally there is a lesion of the urino-genital organs and conjunctiva;
• other types of reactive arthritis;
• reactive arthropathy, unspecified, in the case of a joint injury like reactive arthritis, there are still a number of gaps that are gradually being clarified.

Reactive arthritis can occur in several forms:

• acute - the disease lasts less than 2 months;
• lingering - duration ranges from several months to a year;
• chronic reactive arthritis - lasts longer than 12 months;
• relapsing form - the disease becomes aggravated and the gap between exacerbations is less than half a year.

How does the disease manifest itself?

The initial stage of the disease usually proceeds in an acute form. Most often, the primary signs appear 12 to 14 days after infection. If reactive arthritis develops, the symptoms of the initial stage may be as follows:

1. Increased temperature in the area of ​​the affected joint. This symptom can be determined by placing a palm on a painful patch.
2. Swelling of the joints - this is how reactive arthritis of the knee, ankle, elbows, and also hands and feet manifests itself. In some cases, swelling is beyond the limits of the lesion.
3. Appearance of pain syndrome. Soreness occurs when the affected limbs move - upper or lower. The pains can be different: they are wise, twisting or aching, they are more intense in the daytime and somewhat subside in the night. This symptom can be detected during palpation of affected areas.

Patients will learn what is the joint syndrome - pain, asymmetric oligoarthritis, damage to the joint tissues, edema and others.

In addition, there is a characteristic symptomatology depending on the infectious disease. Urogenital infections are accompanied by urethritis, cervicitis. The joint gap widens, the periarticular edema of the soft tissue arises.

Also for reactive arthritis is characterized by inflammation of the eyes, skin, conjunctiva, mucous surfaces of the oral cavity, etc.

Already at the initial stages of the disease, the patient exhibits symptoms of sacroiliitis (vertebral lesions), kidney disease, heart muscle, impairment in the activity of the nervous system.

After 4-5 weeks after infection, the infection manifests itself as a lesion of large joints that carry the maximum load - reactive arthritis of the ankle, hip, knee, also suffers foot and large toes.

Diagnosis of pathology

Articular diseases require serious approach and mandatory thorough examination. Diagnostics includes the following:

• general blood test - arthritis shows high ESR, increased number of leukocytes, similar results are shown in rheumatoid arthritis;
• general urine analysis - reveals the pathological condition of the kidneys and urethra;
• blood test for C - reactive protein - plasma protein, whose concentration increases against the background of the inflammatory process, this indicator is more sensitive than ESR; and although in the acute phase of inflammation are found three dozen protein components - C - reactive protein is the central components.
• cultural urogenital testing - identifies the etiologic agent;
• X-ray - in the early stages indicates the presence of periarticular osteoparosis.
• echocardiogram, ECG - with rheumatoid arthritis, the risk of cardiovascular damage increases;
• Ophthalmologist examination for lesions of mucous eyes;
• passing tests to identify rheumatic ailments and uric acid in the serum portion of the blood.

In addition, it is important to examine the affected joints, identify the existing symptoms. A number of tests are designed to identify the type of pathogen: scraping from the urethra, detection of antibodies in the blood, PCR analysis - polymerase chain reaction.

What therapy is used

As already noted, such a pathology of the joints is prone to relapse and transition to a chronic form.

However, if you pay attention in time to the symptoms of reactive arthritis, treatment and prognosis are quite favorable.

Experts warn that you should not self-medicate and brush aside the unpleasant signs of ailment.

The doctor knows how to treat reactive arthritis, usually therapy has two directions - getting rid of the pathogens and eliminating the symptoms of the joint syndrome.

From antibacterial drugs can be prescribed funds that have a wide range of effects:

• Azithromycin, Azithromycin monohydrate;
• Doskitsiklin (analogue of Unidox Solutab);
• Clarithromycin (analogues: Claritrosin, Clarbact);
• Amoxiclav (analogues: Bactoclav, Lyclav, Flemoclav C);
• Erythromycin (analogies: Hermitsed, Eryfluid).

Since antibiotics have a number of serious side effects, it is recommended that they be taken only under the supervision of the doctor and according to the individually prescribed scheme. It is worth noting that antibiotic therapy eliminates the infection, but in no way eliminates the symptoms of arthritis.

With articular same syndrome, they are struggling medically, but using drugs from other groups:

1. Non-steroidal anti-inflammatory drugs - preparations based on Diclofenac (Diklovit, Diclofen, Voltaren and others), Ibuprofen (Ibuklin, Nurofen).
2. Steroid hormones, corticosteroids. kryukookortikoidy - Cortisol, Prednisalon, Dexamethasone and others.

Usually appointed as a complex application - ointments and gels for external application to the area of ​​affected joints and capsules or tablets for oral administration. Such medicines slow down the development of pathological processes, affecting biochemical reactions.

Hormonal drugs also have the risk of developing side effects and many contraindications, therefore they are appointed exclusively by a doctor. Although their influence on immunity is a decrease in the functions of this system, specialists evaluate it as a positive quality in this case.

In addition, to stop the attack of immunity on the cells of the joints, the rheumatologist can prescribe drugs - immunosuppressors, such as methotrexate, that prevent cells from growing and depressing immune functions organism. Naturally, the weakening of immunity is a fairly serious condition, and the body in this case is vulnerable to pathogens and viruses.

If reactive arthritis is not treated, then a number of serious complications are possible:

• if there is uveitis, then without cataract treatment;
• destruction of the joint tissues can lead to the formation of erosions, which most often appear on the feet and lead to their deformation changes;
• 12 months of development of arthritis is enough to make it become a chronic ailment.

Like any form of ailment, reactive disease requires long-term therapy, although in contrast to other types of arthritis in this case there is the possibility of complete disposal of pathological changes.

Man's joints are an important component, without their normal functioning the person turns out to be limited in movement, suffers from severe pain and risks getting even more serious problems with health.

Is it not enough to take better care of joints and treat them in a timely manner?

A source: https://OrtoCure.ru/kosti-i-sustavy/artrit/reaktivnyj-simptomy-i-lechenie.html

Reactive arthritis - signs, manifestations, drug therapy, complications and consequences

After transfer of extra-articular infection, reactive arthritis develops, which provokes extensive joint damage with the acute need for their further treatment.

Otherwise, the patient faces a disability.

Therefore, if symptoms of a characteristic ailment arise, detailed diagnostics and adequately selected treatment of reactive arthritis are necessary.

What is reactive arthritis?

This disease has an infectious nature, can be triggered by increased activity of harmful bacteria, pathogenic microorganisms of the genitourinary and gastrointestinal tract.

This aseptic inflammation affects the joints, reduces the physical activity of the patient, so arthritis reactive threatens disability.

The exacerbation is asymmetric, and the pathological process, in addition to the joints, is additionally involved tendons, ligaments, mucous membranes, individual areas of the dermis and even lymph nodes in complicated clinical pictures.

There is inflammation due to increased activity of a harmful pathogen, which may become mycoplasma, yersinia, urogenital chlamydial infection, salmonella, enterobacteria, ureaplasma, dysentery bacillus, Trichomonas, Campylobacterium, Shigella, Escherichia coli, clostridium.

Arthritis-provoking factors are:

• long-term antibiotic treatment;
• weakened immunity;
• prolonged hypothermia of the body;
• chronic diseases of the digestive tract, genitourinary system, respiratory system;
• previously transmitted infections;
• genetic predisposition (actual for carriers antigen hla b27);
• infection of the child from the mother in the process of labor.

Symptoms of reactive arthritis

This inflammatory disease is accompanied by acute symptoms, which takes place 2 weeks after an extremely undesirable infection.

When arthritis reactive, rapid movements deliver a number of unpleasant sensations to the patient, and the pain is riveted to the bed, significantly reducing its physical activity. Viral illness is equally manifested in adult patients and children.

Attention is drawn to the following signs of arthritis:

• increased temperature in the area of ​​affected joints;
• visible redness of the skin;
• swelling of the joints, their excretion above the level of the upper layer of the epidermis;
• tenderness of the limb, discomfort during movement;
• the appearance of joint syndrome;
• stiffness of movements;
• edema and enlargement of the joint space, which is evident in laboratory studies;
• problems with eyesight - inflammation of the cornea of ​​the eyes;
• a disorder of the nervous system;
• weakness of the immune system;
• severe weight loss;
• pronounced signs of sacroiliitis;
• fits of fever.

Separately, it is worth highlighting this unpleasant symptom, which combines a group of ailments that spread to the cells directly of the joints, articular bags, approximate tissue.

This pain in the stage of rest and movement, increased swelling, asymmetric oligoarthritis, congestion inflammatory fluid in the joint cavity, redness of the skin in the area of ​​the inflammatory process.

The main thing is not to start the disease, otherwise acute arthritis of the reactive form becomes a chronic diagnosis with a prolonged and not always possible recovery.

Cutaneous manifestations

The development of arthritis reactive begins with an acute allergic reaction of the epidermis. At first the patient does not understand why on the body there were zones of increased puffiness, clearly outlined redness.

Itching, which is traditionally characteristic of allergies, is absent, but the internal feeling of discomfort, smoothly flowing into the acute painful syndrome, rivets to bed, pushes thoughts about the development of a more serious ailment, for example, seronegative spondyloarthritis.

It is important to pay attention to the appearance of urticaria, psoriasisformnyh rashes, hemorrhagic rash.

Eye defeat in arthritis

A valuable component of rapid recovery is the differential diagnosis of arthritis reactive, which helps to distinguish the primary ailment from the similar in symptomatology. The doctor checks the visual acuity, examines the symptoms in the field of ophthalmology.

So, the patient can complain about irritation of the mucosa, the feeling of a foreign body in the eye, conjunctivitis, weakness of visual activity. These are additional symptoms, as reactive arthritis manifests itself, which are taken into account when collecting anamnesis data.

Symptoms of concomitant diseases

Because reactive arthritis is a complication of a primary ailment, it is important to understand that in any clinical picture is more or less pronounced symptoms of the underlying disease mainly infectious nature.

The task of the attending physician is to choose the treatment so that not only productively remove visible symptoms, but also eliminate the underlying cause. Otherwise, reactive arthritis is very difficult to cure.

Here are the types of infection and their manifestations to deal with:

1. Genitourinary infections. Frequent urination, pain while going to the toilet, dysmenorrhea in women, specific discharge from the external genitalia.
2. Intestinal infections: marked signs of dyspepsia, prolonged diarrhea, abdominal pain, nausea, general weakness, vomiting.
3. Respiratory infections. The stiffness of the voice, dry cough, discharge from the nose, other characteristic signs of the common cold.

Reuter's Reagent

Reiter's syndrome includes the following diseases: acute urethritis, conjunctivitis and arthritis. As a complication of these diagnoses, reactive arthritis may develop as one of the manifestations of autoimmune conditions.

Classification of the Reuter triad is the following: sporadic and epidemic forms. In the first case, it is a complication of chlamydia, in the second it is a consequence of increased activity of intestinal infections.

Without consulting a specialist to make a final diagnosis of arthritis reactive is difficult, in addition, you need to pass a large number of tests.

Diagnosis of reactive arthritis

Before you start effective treatment, you need to competently differentiate arthritis reactive.

To do this, a number of laboratory investigations and clinical examinations in a hospital environment are to be performed, and all of their complaints are reported to the attending physician.

In the patient's outpatient card, it is not the name of the disease itself that is indicated, but its code for μb 10 for confidentiality.

General analysis of blood and urine

Such laboratory tests with reactive arthritis show the presence of an inflammatory process in the body, but are not as informative as possible for the final diagnosis.

In the blood, the increase in the rate of erythrocyte sedimentation, the jump in the C-reactive protein is determined.

In addition, with arthritis reactive, stool analysis can be used to determine the nature of the pathogen in a particular clinical case.

Typing of hla-b27 antigen

When specific antibodies appear in the blood, the likelihood of the development of reactive arthritis in the body is high. Having determined the antigen HLA-B27, the doctor conducts more detailed diagnostics using a more advanced PCR method.

Such a study states the presence of genes in DNA, which are responsible for the formation of this antigen of arthritis reactive. Only venous blood is examined, specific preparation is required for the analysis.

Puncture of joints

For medical reasons, it may be necessary to take the synovial fluid in the cavity of the edematous, for example, the knee joint.

Assign a laboratory test for suspected oncology, since it is important to exclude the risk of large-scale destruction of healthy tissues by cancer cells. Such an analysis is appropriate for an unspecified diagnosis of arthritis reactive, when differential diagnosis is difficult.

During the sampling of biological material, the physician uses local anesthesia, then conducts a number of microbiological and cytological studies.

Serological tests

The main goal of laboratory research is the search for specific antibodies in the blood. This is a series of tests that are performed after a patient's blood sample is withdrawn. In the laboratory, a cross-reactivity of the antibodies is observed.

The results are ready the next day, allow the specialist to judge the nature of the progressing pathology, the characteristics of the potential pathogen and the extent of its spread in the body.

In addition, a woman and a man with a suspicion of arthritis reactive will not hurt to perform arthroscopy, but this is an instrumental method of diagnosis.

Ultrasound and X-ray

This is an informative method that determines not only the prevailing form of arthritis, but also potential complications.

So, on the screen of the monitor you can see the erosion of the joint surface, violations in the structure of the joints, periarticular osteoporosis, pathological narrowing of the joint gap, bone spurs, symptoms of the inflammatory process of intervertebral joints.

X-ray examines the integrity of strong shells, bones; whereas the implementation of ultrasound is necessary for a detailed study of tissue pathologies close to the focus. Both procedures are absolutely painless.

How to treat reactive arthritis

If an illness is found, it is necessary to act immediately, and doctors recommend an integrated approach to such a serious health problem.

If the disease will proceed in a facilitated form, while not accompanied by severe symptoms, this does not mean that conservative therapy is inappropriate. It is important to cure arthritis reactive at any stage in a timely manner, otherwise the patient will have disability for the rest of his life.

Photos of clinical patients with complications frighten, so it is important to start treatment immediately - with the admission of prescribed medications.

Antibiotics

The bacteriological sowing carried out helps to identify a pathogenic pathogen and in time to select an effective antibiotic for its extermination.

Antibiotic drugs are treated not only the affected joint, how much the infection of the primary disease, which preceded the pathogenic attack, is eliminated.

When choosing a medical preparation, it is important to take into account the patient's age, liver and kidney function, the stage of a characteristic ailment. Special attention should be paid to the following medicines with antibacterial effect:

1. Macrolides: Azithromycin, Erythromycin, Clorithromycin.
2. Fluoroquinolones: Ofloxacin.
3. Tetracyclines: Tetrciclin.

Anti-inflammatory therapy

Part of the complex treatment of arthritis reactive are non-steroidal anti-inflammatory drugs directed at elimination of pain syndrome, suppression of signs of the inflammatory process, restoration of damaged tissues and joints. This medication for oral and external. Daily dosages are individually indicated by the attending physician depending on the stage of the pathological process. Alternatively, it can be the following medicines:

• Diclofenac;
• Nimesulide;
• Meloksikam;
• Ibuprofen;
• Naproxen.

Immunosuppressors

Since the recurrent arthritis of the reactive form is a consequence of the severe state of immunity, this pathogenic factor must be eliminated in a timely manner.

Doctors strongly recommend the use of a circulating immune complex, while providing an additional intake of immunosuppressors.

Well proven in the prescribed direction the following medications for arthritis reactive:

• Sulfasalazine;
• Methotrexate;
• Azathioprine.

Treatment with folk remedies

The methods of alternative medicine are not less productive in practice, the main thing is to choose the right recipe and prepare it.

When arthritis reactive, diuretics help to remove stagnant fluid in the inflamed articular cavity.

In addition, arthritis reactive can use the following folk recipes, but it is important to complete the course for up to 2 weeks:

1. Clear 20 fruits of dried wild rose, pour 100 ml of boiling water and insist for up to 3 hours under a tightly covered lid. After cooling, add 4 drops of vitamin A in the form of oil, dissolve 4 g of mummy. Stir, move to a glass container, store in a refrigerator. When arthritis reactive, use it on an empty stomach in the morning and evening in a teaspoon.
2. Prepare fresh peel of 8-10 bananas, place in a glass container, then pour, l vodka. Insist alcohol composition for 2 weeks, then use externally. When arthritis reactive rub the affected joints before bedtime, then create the so-called "greenhouse effect."

Diet with reactive arthritis

Since arthritis of the reactive form in joints is dominated by stagnant phenomena, it is necessary to revise the patient's habitual diet and eliminate this pathogenic factor.

The first thing you need to completely abandon the salt and spices, which just contribute to stagnant fluid in the body.

It is recommended to refrain from spicy, salty, fried, fatty, smoked and spicy food, and preferring to give lean dishes cooked by cooking, quenching, steaming. Other valuable recommendations are presented below:

1. Drink green tea, rose hips and chamomile, which have a pronounced diuretic effect.
2. In the menu of the medical day, it is necessary to include natural omega-3 fatty acids, flaxseed oil.
3. With extreme caution, use potatoes, eggplants, tomatoes, banana pulp, sweet peppers.
4. In arthritis, the following are considered to be useful: sour-milk products, cereals, fresh juices, lean meats, fish oil, berries, certain types of fish and seafood.
5. Food should be a correct and balanced vitamins, when as a daily intake of fluid to be dosed.

Consequences of reactive arthritis

Having become aggravated once, the disease will remind you of itself once again with acute relapses with severe pain syndrome. In the future, limited mobility of the once inflamed joints, the spine is not ruled out.

Doctors do not deny the risk of a chronic pathological process.

To exclude the repeated exacerbation of arthritis reactive, it is required to treat the underlying disease in a timely manner, adhere to simple rules of effective prevention.

A source: http://sovets.net/12180-reaktivnyj-artrit.html