Reactive arthritis

Reactive arthritis is called the inflammatory process in a joint arising against the background of or after the postponed acute infection. Most often accompanies urinogenital, intestinal or infectious diseases of a nasopharynx. Treats seronegative spondylarthrites, i.e. arthritises at which developing in biochemical analysis of blood the revmofaktor is not defined.

Emergence frequency at various pathologies is not identical. Most often the following activators cause arthritises: enterobakteriya, chlamydias, mycoplasmas, salmonellas, shigellas, some parasites.

The combination of arthritis, urethritis (cervicitis), conjunctivitis carries the name of a syndrome of Reuters.

Reactive arthritis arises at men more often. Aged people of 20-40 years are ill it more often than persons of more advanced age. Rather often reactive arthritises occur at children.

Reason of development of reactive arthritises

In most cases reactive arthritises arise owing to a special immune response: cross reaction. In this case cells of own organism are distinguished by immune system as alien and autoaggression goes to them – there is an inflammatory process. It occurs in that case when cells of an organism and the activator have similar gene structure and, roughly speaking, the immune system just "confuses" own fabrics to the infectious agent.

Symptoms of reactive arthritis

Reactive arthritis arises in 1-3 weeks more often after the postponed acute infection when, actually, disease symptoms already passed. There are all-infectious symptoms: body temperature increases, there is a fever, the general weakness, the health worsens. On this background there is an inflammation of joints.

More often joints of the lower extremities, especially small joints of fingers are surprised. Can be surprised as one joint, and a little at once.

At reactive arthritis the joint becomes edematous. Hypostasis can be very widespread: fingers become similar to the roller or sausage. Skin over a joint is hyperemic, at a palpation is warmer, than not changed fabrics.

Very often symptoms of reactive arthritis are followed by symptoms of an inflammation of sinews. They are shown in the form of the pains which are projected to the place of a sinew attachment to a bone.

Often reactive arthritis is followed by conjunctivitis, specific damage of skin in the form of rash (a papule or a plaque), discoloration and structures of a nail plate. There can be system signs of an inflammation: increase in regional lymph nodes, and also pericardis, myocarditis, pleurisy, glomerulonephritis.

In most cases reactive arthritises do not bear danger to life in the form of a monosymptom. However diseases can lead the myocarditis accompanying them, a carditis, etc. to an invalidism and even to a lethal outcome. Therefore at emergence even of reactive arthritis, insignificant on clinic, careful inspection of the patient and timely treatment is necessary.

Diagnosis of reactive arthritis

The diagnosis "arthritis" on the basis of survey is made. However, to understand whether it is reactive or proceeds in the form of some independent disease, detailed inspection is necessary.

First of all, carry out the general analyses: blood, urine, calla, biochemical research. Obligatory inspections are blood tests on possible a contagium: definition of antibodies to gonokokka, chlamydias. It is also necessary to carry out a X-ray analysis of all affected joints.

Because reactive arthritises often are followed by defeat of other bodies and systems, consultations of specialists are necessary: urologist, gynecologist, oculist, cardiologist, rheumatologist, and also carrying out inspection of heart, eyes and other internals.

Treatment of reactive arthritis

All treatment of reactive arthritis can be divided on medicamentous and non-drug.

Non-drug includes restriction of a physical activity, at serious defeat up to a bed rest. Fixing of a joint is possible, however this action is not obligatory and is held only for reduction of a pain syndrome. It is possible to put cold on the affected joint. When subsiding an inflammation appoint some physiotherapy and LFK.

Drug treatment of reactive arthritis is begun most often with purpose of an antibioticotherapia after preliminary definition of the activator. The forecast of treatment of reactive arthritis depends on the accuracy of diagnosis.

As auxiliary therapy appoint non-steroidal anti-inflammatory drugs (NPVS): diclofenac, ibuprofen, Nimesulide and other. They will kill an inflammation and pain.

At heavy and critical condition not to do without hormonal therapy. It can be appointed systemically and locally (intra joint administration of drug).

At the long course and high activity of process appoint immunosuppressors: methotrexate, Sulfasalazinum, Azathioprinum. They reduce activity of an immune response.

Timely begun treatment of reactive arthritis at children in connection with not formation of an immune response and frequency of emergence of complications is especially important.

Prevention of reactive arthritis

Prevention of reactive arthritis comes down to prevention of infectious diseases: to hygienic procedures, correct cooking, observance of periods of validity of food.

When developing diseases the adequate treatment appointed by the specialist is necessary. Within the next 1-3 weeks it is worth observing the guarding mode and to avoid repeated infection.