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Reactive Arthritis

(Reiter's Syndrome)

Definition

Reactive arthritis is joint pain and swelling triggered by an infection. It ranges from mild to severe. It often goes away on its own. For some, it can be long lasting.

Causes

Reactive arthritis is usually caused by an infection in the genitals or digestive system. The body overreacts to the infection. This causes inflammation, even after the infection is gone. Genes may also play a role.

Risk Factors

Things that may raise the risk of reactive arthritis are:

  • Chlamydia infection
  • Infections in the digestive system, such as:
    • Salmonella
    • Shigella
    • Yersinia
    • Campylobacter
  • Having a certain gene trait called HLA-B27
  • Family members with certain types of arthritis

Symptoms

Symptoms may occur in the joints, eyes, urinary tract, and genitals.

Symptoms may be:

  • In the joints:
    • Swelling, pain, and redness
    • Heel pain
    • Back pain and stiffness
  • In the eyes:
    • Redness
    • Burning
    • Blurred vision
    • Tearing
    • Discharge
  • In the urinary tract or genitals:
    • Burning feeling when passing urine
    • Discharge from the penis

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. There is no specific test to check for reactive arthritis.

Tests may be done to look for problems and infection. They may include:

  • Blood tests
  • Urine tests
  • Stool tests
  • Removal of fluid from the affected joints

X-rays may be done to look at bones and joints.

Treatment

Most people get better within 12 months. Others develop mild, long term arthritis. Some may have symptoms that keep coming back.

The goal of treatment is to ease symptoms. Options may be:

  • Rest, and support devices—to ease strain on the joints
  • Physical therapy—to improve movement and joint function
  • Medicines, such as:
    • Nonsteroidal anti-inflammatory drugs (NSAIDs)
    • Corticosteroid by injection, or cream
  • Disease-modifying antirheumatic drugs (DMARDS)
  • TNF inhibitors
  • Antibiotics—to treat chlamydia
  • Eye drops

Prevention

To reduce the risk of reactive arthritis:

  • Practice safe sex.
  • Wash hands before eating or handling food.
  • Only eat foods that have been stored and prepared properly.
RESOURCES:

Arthritis Foundation
http://www.arthritis.org

National Institute of Arthritis and Musculoskeletal and Skin Diseases
https://www.niams.nih.gov

CANADIAN RESOURCES:

Arthritis Society
https://www.arthritis.ca

Public Health Agency of Canada
https://www.canada.ca

REFERENCES:

García-Kutzbach A, Chacón-Súchite J, et al. Reactive arthritis: update 2018. Clin Rheumatol. 2018;37(4):869-874.

Questions and answers about reactive arthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: https://www.niams.nih.gov/health-topics/reactive-arthritis. Accessed April 1, 2021.

Reactive arthritis. American College of Rheumatology website. Available at: https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Reactive-Arthritis. Accessed April 1, 2021.

Reactive arthritis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/reactive-arthritis . Accessed April 1, 2021.

Last reviewed December 2020 by EBSCO Medical Review Board David L. Horn, MD, FACP  Last Updated: 4/1/2021