Current principles of diagnosis and treatment of reactive arthritis

Abstract

Introduction. Reactive arthritis is an autoimmune inflammatory rheumatic disease which develops as a reaction to urogenital or intestinal infections. Clinical Signs and Symptoms. It manifests as a peripheral asymmetrical monoarthritis or polyarthritis, mainly involving the lower extremities. Apart from joints, it can also affect the spinal cord, but also involve the muscle attachment sites, tendons, bursae, conjunctiva, anterior segment of the eye, damage to the skin and mucous membranes, causing typical asymmetrical sausage-like edema of fingers and/or toes. Diagnosis. The diagnosis is based on the Berlin Diagnostic Criteria including the characteristics of peripheral arthritis and evidence of previous infection. Approximately 65% - 85% of patients with reactive arthritis are positive for human leukocyte antigen - B27. Treatment of Reactive Arthritis. The therapy includes antibiotics chosen according to the antibiogram for the causative agent of the infection. The therapy is aimed at pain management and control of the autoimmune response of synovial lining of the joints, i.e. at prevention of articular damage. Drug therapy includes non-steroidal anti-inflammatory drugs, analgesics, steroids, immunosuppressive agents and biological drugs. Other methods of treatment are also recommended, such as rest in the acute phase of the disease, physical therapy and patient's education. Conclusion. Development of new diagnostic methods, particularly molecular diagnostics, and new therapeutic modalities using new generation drugs, has created conditions for more efficient treatment of reactive arthritis.