Reactive arthritis
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Reactive arthritis
Pathology
Pediatric musculoskeletal conditions
Radial head subluxation (Nursemaid elbow)
Developmental dysplasia of the hip
Legg-Calve-Perthes disease
Slipped capital femoral epiphysis
Transient synovitis
Osgood-Schlatter disease (traction apophysitis)
Musculoskeletal injuries and trauma
Rotator cuff tear
Dislocated shoulder
Radial head subluxation (Nursemaid elbow)
Winged scapula
Thoracic outlet syndrome
Carpal tunnel syndrome
Ulnar claw
Erb-Duchenne palsy
Klumpke paralysis
Iliotibial band syndrome
Unhappy triad
Anterior cruciate ligament injury
Patellar tendon rupture
Meniscus tear
Patellofemoral pain syndrome
Sprained ankle
Achilles tendon rupture
Spondylolysis
Spondylolisthesis
Degenerative disc disease
Spinal disc herniation
Sciatica
Compartment syndrome
Rhabdomyolysis
Bone disorders
Osteogenesis imperfecta
Craniosynostosis
Pectus excavatum
Arthrogryposis
Genu valgum
Genu varum
Pigeon toe
Flat feet
Club foot
Cleidocranial dysplasia
Achondroplasia
Osteomyelitis
Bone tumors
Osteochondroma
Chondrosarcoma
Osteoporosis
Osteomalacia and rickets
Osteopetrosis
Paget disease of bone
Osteosclerosis
Lordosis, kyphosis, and scoliosis
Joint disorders
Osteoarthritis
Spondylosis
Spinal stenosis
Rheumatoid arthritis
Juvenile idiopathic arthritis
Gout
Calcium pyrophosphate deposition disease (pseudogout)
Psoriatic arthritis
Ankylosing spondylitis
Reactive arthritis
Spondylitis
Septic arthritis
Bursitis
Baker cyst
Muscular disorders
Muscular dystrophy
Polymyositis
Dermatomyositis
Inclusion body myopathy
Polymyalgia rheumatica
Fibromyalgia
Rhabdomyosarcoma
Neuromuscular junction disorders
Myasthenia gravis
Lambert-Eaton myasthenic syndrome
Other autoimmune disorders
Sjogren syndrome
Systemic lupus erythematosus
Mixed connective tissue disease
Antiphospholipid syndrome
Raynaud phenomenon
Scleroderma
Limited systemic sclerosis (CREST syndrome)
Musculoskeletal system pathology review
Back pain: Pathology review
Rheumatoid arthritis and osteoarthritis: Pathology review
Seronegative and septic arthritis: Pathology review
Gout and pseudogout: Pathology review
Systemic lupus erythematosus (SLE): Pathology review
Scleroderma: Pathology review
Sjogren syndrome: Pathology review
Bone disorders: Pathology review
Bone tumors: Pathology review
Myalgias and myositis: Pathology review
Neuromuscular junction disorders: Pathology review
Muscular dystrophies and mitochondrial myopathies: Pathology review
Pediatric musculoskeletal disorders: Pathology review
Assessments
Reactive arthritis
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Reactive arthritis
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Arthritis p. 476
reactive arthritis p. 479
Campylobacter spp.
reactive arthritis and p. 479
Chlamydia spp. p. 146
reactive arthritis p. 479
Conjunctivitis p. 553
reactive arthritis p. 479
Reactive arthritis p. 479
Campylobacter jejuni p. , 143
chlamydia p. 146, 180
HLA-B25 and p. 98
presentation p. 718
Salmonella spp.
reactive arthritis p. 479
Shigella spp.
reactive arthritis p. 479
Urethritis
reactive arthritis p. 479, 718
Yersinia spp.
reactive arthritis p. 479
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Transcript
Contributors
Harry Delaney, MBChB
Tanner Marshall, MS
Reactive arthritis, formerly known as Reiter’s syndrome, is inflammation of a joint which usually develops after an infection, and that infection is typically a sexually transmitted disease or gastroenteritis. Reactive arthritis is part of a group of diseases called seronegative spondyloarthropathies. Spondyloarthropathies are autoimmune, inflammatory joint diseases, and they’re seronegative, which refers to the fact that an auto-antibody called rheumatoid factor is absent from the blood.
Normally, the immune cells are ready to spot and destroy anything foreign that could cause the body harm. To help with this, most cells in the body have a set of proteins that combine together to form something called a major histocompatibility complex, or MHC, and this is a molecule that sits on the surface of their cell membrane. There are two kinds of MHC molecules, class I and class II. Class I molecules are found on most cells in the body, and they present molecules from within the cell for the immune system to continually sample. Normally the molecule’s just a sample from inside the cell, also known as a self-antigen. When immune cells pass by, they recognize this self-antigen as harmless so there’s no response.
MHC class II molecules are found specifically on phagocytic cells like macrophages which destroy and digest foreign pathogens like bacteria. Once a macrophage destroys a bacterium, it presents a piece of that bacterium on its MHC class II receptor, and the macrophage then makes its way to the lymph node to find some T-lymphocytes. A type of T-lymphocyte, called a CD4+ T-cell, also known as a helper T-cell, uses its T-cell receptors to bind to the foreign antigen presented by the MHC class II molecule. If the helper T-cell binds strongly, the antigen is recognized as foreign, and the helper T-cell switches on the corresponding B-cell, so it can start producing a whole lot of antibodies. These antibodies bind to the specific pathogen, and typically prevent it from attacking the host’s cells and, at the same time, they “tag” the pathogen for further destruction by other immune cells.
Summary
Reactive arthritis, originally referred to as Reiter's arthritis, is an autoimmune condition commonly affecting the joints, skin, and eyes, which develops in response to an infection in another part of the body. Reactive arthritis commonly presents as inflammatory arthritis of large joints, conjunctivitis or uveitis, and urethritis in men or cervicitis in women. Symptoms include joint pain and swelling, pain and swelling in the eyes, pain with urination, pain with sexual intercourse in females, and skin rashes. Treatment focuses on identifying and treating the culprit infection with antibiotics, and anti-inflammatory drugs to dampen the inflammation.
Sources
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
- "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
- "Poststreptococcal Arthritis" Canadian Journal of Infectious Diseases (1995)
- "Risk Factors for Progression from Subclinical to Clinical Phase of Psoriatic Arthritis: A Case–Control Study" Rheumatology and Therapy (2021)
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