Reactive arthritis

Description:

Reactive arthritises - the "sterile" not purulent arthritises developing in response to an extraarticular infection at which the alleged etiological infectious agent is not allocated from a joint when using usual mediums.

The term "reactive arthritis" is offered Anhoven and соавт. in 1969. Now it is established that at reactive arthritises in joint fabrics antigens of microbes come to light (iyersiniya, salmonellas, chlamydias). However, there were messages that at reactive arthritises also the microorganisms capable to reproduction in culture of cells can be allocated from joint fabrics.

Now it is offered to carry to reactive arthritises only the arthritises connected with an intestinal and urinogenital infection and associated with HLA B27 antigen, at the same time the rhematoid factor in blood serum is not found.

Symptoms of Reactive arthritis:

1. The previous or at the same time developed urethritis or diarrhea.
2. Damage of eyes (conjunctivitis, iritis).
3. Asymmetric arthritis of the lower extremities (as a rule, knee, ankle joints and joints of fingers of feet are surprised, and process carries mono - or oligoartikulyarny character).
4. Sosiskoobrazny defiguration of fingers of feet.
5. Frequent damage of an Achilles tendon and a bottom aponeurosis with the expressed pains.
6. Foot thumb arthritis, pain and a swelling in heels.
7. Lack of the Russian Federation in blood.
8. Existence of HLA B27.
9. Asymmetric sacroileitis.
10. Radiological signs of calcaneal spurs, periostitis of ossicles of feet, juxtaspinal ossification.
11. Reactive arthritises are inclined to full involution for 4-6 months, but can recur and even to get a chronic current with involvement of an increasing number of joints.

Reasons of Reactive arthritis:

Depending on an etiology distinguish two groups of reactive arthritises:
- postenterokolitichesky (activators: an iyersiniya - serotypes 03 and 09; the salmonella - is more often than Salmonella thyphimurium; the shigella - a dysenteric stick, is more often than Shigella Flexneri; kampilobakter; clostridium); at an acute iyersinioz reactive arthritis develops in 20%, at a salmonellosis - in 2-7.5%, at a shigellosis - in 1.5%, at a campilobacteriosis - less than in 1% of cases.
- urogenital (activators: chlamydias - serotypes D-to; ureaplasma; and also associated with HIV infection).

Treatment of Reactive arthritis:

Treatment of reactive arthritis long, takes, as a rule, half a year, but sometimes to one and a half years.

Appoint reception of antibiotics within 30–40 days, antiinflammatory drugs for simplification of pains, and also slowly operating antirheumatic drugs which need to be accepted within several months.

Most often reactive arthritis is treated successfully, any more never repeats, but sometimes nevertheless becomes chronic or will be transformed to other rheumatic diseases.