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Reactive Arthritis and Reiter Syndrome Page 1
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Reactive arthritis (ReA)  
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Joint Inflammation

When to seek medical advice

Contact your doctor if you develop signs and symptoms that may indicate reactive arthritis. Also contact your doctor if you're being treated for the disease and new signs and symptoms develop.

Screening and diagnosis

Reactive arthritis can go undiagnosed for a long time because your signs and symptoms may be mild. In many cases, however, people with undiagnosed reactive arthritis first visit their doctor when one of their joints, such as a knee, ankle, or other large joint, suddenly becomes swollen.

Your doctor will perform a physical exam — which may include examining your joints, checking your skin for lesions and examining your eyes for inflammation. Your doctor may ask you about your medical history, including current symptoms and any past infections you've had.

No specific test shows whether you have reactive arthritis. Instead, your doctor may perform a number of tests to help confirm a suspected case of reactive arthritis and to rule out other conditions.

  • Cultures. Your doctor may perform cultures to see if you have any of the infections often associated with reactive arthritis. These tests involve placing samples of bodily fluids onto a substance that enhances the growth of bacteria. Any bacterium that grows is identified, and your doctor will discuss recommendations for treatment.

  • Some bacteria are difficult to grow in the laboratory, so other microbiologic tests may be performed. Alternatives include blood tests that detect antibodies against bacteria (serologic tests) and polymerase chain reaction (PCR) — a test that can identify portions of genetic material (DNA). For example, chlamydia is a common precursor to reactive arthritis. Early identification and treatment of chlamydia may slow the progression of reactive arthritis.

  • Your doctor may rule out other infections associated with reactive arthritis by collecting samples from your throat, urethra (in men) and cervix (in women) with a cotton swab and then testing the samples. Your doctor may have you collect urine or stool samples, which can be tested for infections. Finally, joint fluid samples can be collected with a needle and tested.

  • Sedimentation rate. Your doctor may check a blood test to see if you have an elevated sedimentation rate — which is the speed at which your red blood cells settle to the bottom of a tube. An elevated rate can indicate inflammation. People with reactive arthritis often have an elevated sedimentation rate.

  • Rheumatologic tests. Your doctor may try to look for an alternative diagnosis to reactive arthritis by performing rheumatoid factor and antinuclear antibody tests. Rheumatoid factor is an antibody often found in the blood of people with rheumatoid arthritis. Antinuclear antibodies are proteins that are generally found in people who have connective tissue or autoimmune disorders. If you have reactive arthritis, you'll probably test negative on both of these tests.

  • X-rays. X-rays of your joints can indicate whether you have any of the characteristic signs of reactive arthritis, including soft tissue swelling, calcium deposits where tendons attach to bones and cartilage damage. X-rays can also rule out rheumatoid arthritis.

  • Gene tests. You may undergo a blood test to see if you carry the HLA-B27 gene. Though the presence of this gene doesn't necessarily mean you have reactive arthritis, it may help with the diagnosis. Reactive arthritis can also occur in people without this gene.


For most people, signs and symptoms of reactive arthritis come and go over time, eventually disappearing within 12 months. You may experience relapses, but the resulting signs and symptoms will probably be mild.

A small number of people develop chronic arthritis, which — if not controlled by treatment — can lead to joint deformity.

In some cases, reactive arthritis can lead to the following complications:

  • Uveitis. This condition causes inflammation of your uvea, which is the middle layer of your eye. You may experience light sensitivity, redness, pain, floaters and blurry vision. Uveitis can cause permanent vision loss if not detected and treated early. This condition can recur.

  • Arrhythmia. This is an abnormal heart rhythm that results from damage to your heart's electrical conduction system. You may need to use a pacemaker. This is an uncommon complication of reactive arthritis.

  • Aortic insufficiency. In this condition, also called aortic valve regurgitation, your heart's aortic valve doesn't close tightly. As a result, blood flows backward from the aorta, the largest blood vessel that carries blood away from your heart, into the left lower chamber of your heart (left ventricle). This occurs during diastole, in which the heart muscle relaxes after a contraction and the ventricles fill with blood. This is an uncommon complication of reactive arthritis.

Arthritis, reactive > 1 > 2 > 3


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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
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