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Reactive arthritis

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 3 minutes read

Reactive arthritis is a reaction that occurs in your body, usually after you’ve had some sort of infection. It causes an arthritis-type response in your joints with symptoms of swelling, redness, and inflammation. Commonly it affects the joints of the lower body, including the knees and hips, but it can also affect any joint. In the majority of cases, there are no long-term complications, although it can take a few months to clear up completely.

What are the symptoms of reactive arthritis?

The symptoms are more common in men but can affect both genders. Inflammation of the joints can lead to pain, swelling, and stiffness. But in others, it can also affect the eyes and the genitals. The genitals may have discharge or pain when passing urine in both men and women. The eyes can become sticky with discharge, painful, and red, and sometimes there can also be inflammation (iritis).  If you get any eye symptoms, seek immediate attention.

What are the causes of reactive arthritis?

Reactive arthritis often occurs after a recent infection. The exact mechanism of action is unclear, but the initial infection causes an immune response and, in some people, leads to an overreaction of the immune system. This overreaction can lead to other cells and tissues becoming inflamed soon after. Most commonly, it is due to sexually transmitted infections like chlamydia, but tummy infections like gastroenteritis or glandular fever can also cause it. Some people have a specific gene called HLA-B27, which puts them at risk of developing reactive arthritis.

What will my doctor do?

Reactive arthritis is a diagnosis of exclusion, which means no test can identify it. Your doctor will ask you about symptoms and your medical and sexual history. Your doctor may need to rule out other causes or find evidence of a recent infection. This can be done through several investigations, such as blood tests, urine samples, stool samples, and sexually transmitted infection (STI) swabs.

Your doctor may request imaging such as ultrasound scans or X-rays. If your doctor thinks reactive arthritis may be the diagnosis, they can refer you to specialist doctors, such as an eye doctor if you have problems with your eyes or an arthritis specialist if you have problems with your joints.

How can reactive arthritis be treated?

Reactive arthritis usually lasts from a few months up to a year. If your symptoms include pain, your doctor will recommend painkillers such as ibuprofen which can help reduce inflammation, helping reduce pain, and swelling. If you have a sexually transmitted infection, your doctor will prescribe antibiotics to help clear the infection. Suppose the joint pain and swelling (arthritis) are prolonged or severe. In that case, the arthritis specialist may suggest starting medication such as immune-modulating drugs such as steroids or stronger drugs called disease-modifying anti-rheumatic drugs (DMARDs).

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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