Reactive arthritis

This describes a condition in which the joints become inflamed due to a gastrointestinal infection such as food poisoning or following a urinary infection.

It affects people of all ages and is also known as ‘Reiter’s Syndrome’.It is, however, relatively uncommon.

The difference between this and other forms of arthritis is that this disease occurs as a reaction (hence the term ‘reactive’) to an inflammation in another part of the body, for example the intestine. This infection may be bacterial of viral food poisoning.

Other types of arthritis develop as an infection within a joint, e.g. the knee joint.

Causes of reactive arthritis

To start with, what are ‘reactive’ symptoms?

No-one is sure as to why reactive symptoms occur in areas of the body where there isn’t an infection. An example of this is if someone develops bacterial food poisoning which then causes a reaction in the knee or ankle joints.

This reaction takes the form of an inflammation.

What has been suggested is that when you develop an infection your immune system produces antibodies which fight off bacteria or viruses responsible for causing the infection.

This conflict between your immune system and the infection often results in ‘debris’such as chemicals and bits of dead germs which are the fallout from this. Some of this debris may spread into the bloodstream where it travels to other areas of the body.

If this debris accesses a joint such as the knee joint then it causes inflammation in that joint.

Apart from food poisoning, there are several other infections which cause reactive arthritis and include:

• Viral infections, e.g. coughs and colds
• Urethritis (infection of the urethra)
• HIV

Reactive arthritis caused by food poisoning occurs due to a range of bacteria which include: salmonella, e coli, yersinia, campylobacter and shigella.

So, if you have had food poisoning caused by any of these bacteria then you are at greater risk of developing this form of arthritis.

Reactive arthritis usually affects men more than women. The main reason for this is that men are at greater risk of urinary infections due to sexually transmitted diseases. But anyone can develop this disease.

Symptoms of reactive arthritis

The incubation period of this disease is 2 to 4 weeks following the original infection. So, if you had a bout of food poisoning a couple of weeks ago then you may develop reactive arthritis around this time.

This is the case even if your food poisoning has cleared.

Joint symptoms

The symptoms affect the joints as well as other areas of the body. The joints that are most commonly affected are the knees, ankles and the base of the spine but any joint can be affected.

More then joint can be affected. The inflammation starts with a stiffness in that joint followed by pain and swelling. This pain varies from mild to severe and between individuals.

The ligaments and tendons that surround a joint can also be affected, which results in a swollen, tender appearance.

Other symptoms

These symptoms occur in at least half of all cases and before or following those symptoms which affect the joints.

They include:

• Conjunctivitis (an inflammation of the front of the eye)
• Urethritis
• Mouth ulcers
• Scaly rash on the hands and feet
• Fever
• Weight loss
• Fatigue
• Inflammation at the end of the penis (known as balanitis)
• Thickening or brittle appearance of the nails

Diagnosing reactive arthritis

Your GP will be able to diagnose this from observation of your symptoms and asking you about your medical history. If you have recently experienced a bout of food poisoning then mention that to him/her if you have not previously done so.

If you have had food poisoning then you may be asked to provide a stool sample for analysis.

There is no specific test for reactive arthritis but there are several standard tests which are performed for investigative reasons for an illness. These include blood and urine tests and X-rays.

Your symptoms may indicate another form of arthritis such as rheumatoid arthritis so you may be referred for tests in order to rule this out.

If you developed an eye condition known as ‘uveitis’as a result of this disease then you will be referred to an eye specialist. Uveitis is a deep rooted inflammation within the eye which requires medical attention.

Treatment for reactive arthritis

If this has been caused by bacterial food poisoning then antibiotics can be prescribed to treat this. However, most cases of food poisoning clear up without the need for treatment.

Painkillers such as anti-inflammatories are given to ease any pain, swelling and stiffness in your joints. Steroids are another option.

Excess fluid around the joints can be removed via a needle and syringe which will draw off this fluid. This will also ease any pain.

Rest your joints until the symptoms start to ease but get them moving as soon as you can as it is vitally important to stay active. Ask about suitable exercise routines and consider having physiotherapy.

In some cases the symptoms disappear after a few weeks but in most cases, it can take several months before they do so. Plus it is not uncommon to experience a few pains afterwards which last for a few months longer. Some people find that they experience these symptoms for a number of years.