Reactive arthritis( ReA) is an inflammatory joint damage that 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
This disease can be triggered by various bacterial infectious diseases, often by 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 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 may occur after sexually transmitted 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:
- Before the immediate manifestation of symptoms of arthritis, the child raises the temperature, diarrhea occurs, often runs to the toilet on a small. These same signs can also speak of an intestinal infection( dysentery, salmonellosis) or problems of an infectious nature in the genitourinary system( urethritis, cystitis, chlamydia).
- In reactive arthritis, children have inflammation mainly of the joints of the legs - the ankle, hip or knee joint. The joints increase noticeably in size.
- With active physical exertion, there are quite strong pains.
- Drowsiness, weakness.
- Inflammation of the eyes, tearing, fear of bright light.
If the disease is diagnosed in time, the results of the treatment will be positive, the disposal 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 to four weeks, the patient has an intestinal disorder, acute respiratory disease, or an ailment very similar to cystitis in the initial stage.
Further symptoms of reactive arthritis become classical and conditionally subdivided into three groups:
- inflamed 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);
- develops inflammation in the genitourinary sphere.
In most cases, the initial inflammation occurs in one joint, and only then the disease affects entire articular groups. Clinical manifestations of reactive arthritis range from transient monoarthritis to a fairly severe multi-systemic disease.
Common symptoms include: weakness, general malaise, fever. The severity of these manifestations can be either quite small or very strong.
Polyarthritis or asymmetric oligoarthritis, which mainly affects the toes of the foot or large joints of the lower extremities, can be observed. In severe disease, pain in the back is possible.
How to diagnose?
In order to understand how to treat reactive arthritis, it is necessary to diagnose it initially. 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 the joints;
- the problem occurs in no more than 4 to 5 joints at a time;
- noted asymmetry in joint problems;
- has the most problems with leg joints.
Symptoms are sometimes quite 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 a disease occurs, 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 performed by rheumatologists. With its parallel development with acute infectious disease, the treating specialist can become an infectious disease doctor.
Since the triggering factor of reactive arthritis is usually infection, one of the most important points of treatment is to rid the body of these infectious agents. On how well this can be done, the outcome of the disease will depend.
The medical treatment of can be divided into several main areas:
- elimination of the inflammatory process;
- therapy for intestinal or respiratory infections;
- therapy for 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 done on an outpatient basis, hospitalization is performed only in cases when the diagnosis is unclear and constant monitoring is required, as well as with very severe manifestations of the disease and general severe condition.
Forecast of the disease
For patients who underwent complex treatment for reactive arthritis, there is the following prognosis for further life:
- In 20% of cases the symptoms disappear within 6 months;
- After a properly selected treatment there is no recurrence of the disease;
- In 25% of cases, reactive arthritis passes into the chronic stage, progressing only in the phase of exacerbation;
- In 50% of cases the disease starts to progress with a new force after a certain period of time;
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 noted that some vegetables of the Solanaceae family can cause an exacerbation of the disease and intensify the symptoms of reactive arthritis. Therefore, use potatoes, tomatoes, eggplant and sweet peppers with caution. The diet should be balanced: no low or high-calorie diet is indicated.