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Symptoms and treatment of reactive arthritis

07 Sep 18

Causes, symptoms and treatment of reactive arthritis

Reactive arthritis has an ICD 10 code - M02. Joint damage is associated with the development of infection, however, the reaction of the immune system is of great importance, which allows the infection to develop. The duration of the incubation period is 2-4 weeks. Detection of the disease is complicated by the fact that rheumatoid and reactive arthritis can develop simultaneously.

Factors in the development of the disease

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In most cases, joint damage occurs in people aged 20-40 years. The pathology most often occurs in males, occurring after a genitourinary infection. In women, the disease appears after the development of an intestinal infection. However, reactive arthritis also forms in children, most often appearing at the age of 9-14 years.

The causes of arthritis are associated with the presence of an abnormal antigen in the DNA, so the development of a urogenital or gastrointestinal infection leads to the activation of immune T-lymphocytes. As a result of this process, tissue damage occurs to the patient.

The causes of enretoarthritis are associated with poisonings caused by the following bacteria and conditions:

Reactive arthritis also occurs when the genitourinary system is affected by the following infections:

The development of the disease occurs not only during the acute stage of infection. Prolonged exposure to the pathogen also has a negative effect. In most cases, the cause of joint damage is associated with the activity of chlamydia. In some cases, pathology occurs after immunization. The following ways of spreading urogenital diseases are distinguished:

  • Contact and household.
  • Sexual.
  • Infection during labor.
  • Intestinal pathologies penetrate in the following way:

    Depending on the cause of the development of reactive arthritis, the following types are distinguished:

  • Post-immunization arthritis.
  • Reiter's syndrome.
  • Urogenital type.
  • Postenterocolic form.
  • Stages of development differ in duration and signs of the disease:

  • The acute form lasts up to 6 months;
  • The chronic type occurs 6 months after the first onset of arthritis;
  • The recurrent form may occur a year after the completion of the acute stage.
  • Symptoms of reactive arthritis may appear immediately or after some time. Localization of signs is associated with large articulations of the joints:

    In most cases, there is a unilateral nature of inflammation of the joints. The disease affects one or more joints, but inflammation can affect several groups at once:

  • Small joints;
  • Cervical and lumbosacral spine;
  • Tendons and ligaments;
  • Sternum;
  • Collarbone.
  • The main symptoms of reactive arthritis are presented as follows:

  • Fingers and toes swell.
  • Hyperthermia of the skin is observed around the affected area - a local increase in temperature.
  • Edema and swelling forms.
  • After waking up, the joints are stiff.
  • When palpating, discomfort and unpleasant sensations occur.
  • The pain is dull or aching or shooting in nature.
  • The pain intensifies at night or with movement.
  • Reactive arthritis is also represented by systemic symptoms:

  • Damage to nerve trunks;
  • Inflammatory process in the kidneys;
  • Painful sensations in the heart area;
  • Enlarged lymph nodes.
  • Against the background of reactive arthritis, manifestations of infection occur, which led to the formation of the disease. For this reason, rashes may occur on the patient's skin, and the mucous membranes will be irritated. The condition is dangerous as it can lead to complications. In childhood, there is a risk of developing juvenile-type spondyloarthritis. Dangerous complications are glomerulonephritis and myocarditis.

    Diagnosis is an important step, so if signs appear, you must consult a doctor. Diagnostics includes the following methods:

    1. PCR analysis.
    2. Blood test: biochemical and clinical analysis.
    3. General urine analysis.
    4. Fibercolonoscopy.
    5. Stool culture to determine microflora.
    6. Determination of other blood characteristics: sialic acids, antigens and antibodies.
    7. Computed and magnetic resonance imaging.
    8. Linked immunosorbent assay.
    9. Sigmoidoscopy.
    10. Taking swabs from the urethra or cervical canal.
    11. X-ray of the limbs, spinal column and other affected joints.
    12. Diagnosis of reactive arthritis is also based on criteria that can confirm the presence of the disease:

    13. Damage to the lower extremities;
    14. Asymmetric form of oligoarthritis. In this case, the inflammation is localized in several joints;
    15. Presence of symptoms of infection or presence of illness in the past.
    16. Primary diagnostic data are also important, since primary manifestations can be detected. X-rays can detect even the smallest changes. Thanks to hardware diagnostics, calcifications located on bone tissue are detected. X-rays are also needed for long-term pathology in the joints.

      Even “advanced” ARTHRITIS can be cured at home! Just remember to apply this once a day.

      The presence of an inflammatory process in the eyes requires a visit to an ophthalmologist. For differential diagnosis, it is necessary to compare the presented form of arthritis with other diseases and types of arthritis:

      How to treat reactive arthritis? The basis of therapy is drug tactics aimed at eliminating signs of the disease and manifestations of infection. Only a specialist selects means and methods. Antibiotic drugs are of great importance, which are used taking into account the nature of the infection. Antibiotic treatment is carried out for a week, and after 3 weeks a diagnosis is carried out.

      For chlamydial infection, the following drugs are used:

      For intestinal infections, use your own medications. A feature of the therapy is the appointment of the presented group after therapy with immunosuppressants. The following medications are used for treatment:

      Additionally, complexes with vitamins and enterosorbents are used. Non-steroidal anti-inflammatory drugs are used for oral administration:

      Elimination of pain is an important task during therapy, therefore injections of glucocorticosteroids are administered in the area of ​​painful joints:

      Treatment of reactive arthritis with rapid development or the presence of complications requires the use of immunosuppressants:

      If immunosuppressants do not bring the desired result, then they resort to the help of monoclonal antibodies. A representative of this group is the drug Infliximab . They resort to local therapy, for which ointments with NSAIDs are prescribed. The drug Dimexide has good effectiveness, which can be used simultaneously with NSAIDs.

      Non-drug tactics are associated with providing rest for sore areas. It is useful to use physical therapy complexes. The selection of exercises is carried out only by a specialist. To improve well-being and ensure the best result, physiotherapeutic methods are prescribed:

    17. Mud therapy.
    18. Applications with paraffin.
    19. Microcurrent therapy.
    20. Cryotherapy.
    21. Gymnastics and traditional medicine

      Reactive arthritis requires the use of gymnastics. This treatment improves blood flow and relieves symptoms. During the event, you need to perform movements smoothly. Classes are held every day, duration is 15-30 minutes. Use the following exercises:

    22. Squats;
    23. Rotation of the hands;
    24. Circular movements of the neck;
    25. Flexion and extension of fingers;
    26. Warm-up for the shoulders - performing rotation;
    27. Tilts in different directions;
    28. Rotations in the elbow joint;
    29. Rotations at the ankle joint;
    30. Exercise bike;
    31. Abduction of legs to the sides;
    32. Swing your legs.
    33. Reactive arthritis can be treated with traditional medicine, which successfully complements official treatment. For the first recipe you will need the following components:

      Each ingredient is taken in an amount of 10 g. The mixture of components is brewed in a glass of boiling water. To prepare the composition you will need 1 spoon of the mixture. After 3 hours of infusion, take 1 glass during the day, so the product is divided into equal portions.

      In a similar way, a composition is made from the following ingredients:

      If reactive arthritis is characterized by severe pain in the joints, then a recipe made from horseradish and radish is suitable. You need to take the components in equal proportions, grind them, and then add a small amount of baby cream. The mixture is applied to sore joints. After 1-2 hours, the product needs to be washed off.

      Comfrey ointment will help relieve pain. The leaves of the plant are crushed, then poured with the same amount of vegetable oil. The product is boiled for 20 minutes over low heat. A spoonful of Dimexide and 5 ml of vitamin E are added to the composition. To use, apply the medicine to a compress and apply it to the affected areas. The compress is applied for half an hour.

      Prevention and lifestyle

      The development of reactive arthritis can be prevented. To do this, it is important to follow the rules of prevention:

    34. During epidemics, take steps to ensure your protection.
    35. Eat fresh food.
    36. Avoid hypothermia.
    37. Lead a healthy lifestyle.
    38. Treat emerging diseases in a timely manner.
    39. Have one sexual partner.
    40. Maintain hygiene.
    41. If reactive arthritis appears, the patient should undergo a massage course. During the procedure, ointments with anti-inflammatory components are used, which increases the effectiveness of the technique. It is recommended to follow a diet that will help the body cope with infections or other diseases. The patient should avoid eating fried foods and foods containing animal fats. Smoked meats and spices are also prohibited. It is recommended to drink rosehip decoction. It is useful to introduce fresh vegetables and fruits into your diet.

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        Symptoms and treatment of reactive arthritis

        Reactive arthritis is inflammation of the joints that occurs against the background of an infectious disease in the body. Depending on which causative agent of the infection that caused inflammation of the joints was identified during diagnosis, urogenital and postenterocolitic reactive arthritis are distinguished. In the first case, the disease develops after suffering from chlamydia, trichomoniasis and other sexually transmitted infections, in the second case, when salmonella or dysentery bacillus enter the body.

        Symptoms of reactive arthritis

        If there is any other infection in the body, for example, conjunctivitis, the symptoms of reactive arthritis are accompanied by decreased vision, lacrimation, and redness of the eyes. Inflammation of the joints against the background of an intestinal infection can be accompanied by upset stool, nausea, prolonged vomiting, loss of consciousness, and fever.

        Quite often this disease occurs in children of any age. In this case, it occurs against the background of intestinal poisoning or as a result of a previous respiratory tract infection. Reactive arthritis in children is a common complication of influenza, acute respiratory infections, acute respiratory viral infections, occurring mainly in the winter season. When the disease occurs, the child begins to complain of shooting pains in the knees or fingers.

        The main symptoms of reactive arthritis in children, as in adults, are swelling of an individual joint or an entire group of joints, pain during palpation, and a slight increase in body temperature at the site of the inflammatory process. Joint inflammation can also be recognized by changes in their behavior. The child becomes less active, is often capricious, may refuse to move around the room, does this carefully, as if limping, often rubs his palms, massages his fingers.

        Diagnosis of rheumatoid arthritis

        How to treat reactive arthritis

        Treatment of reactive arthritis in adults involves the introduction of anti-inflammatory non-steroidal drugs into the patient's body. Local injections of glucocorticosteroids may be prescribed, which involve injecting the drug directly into the site of inflammation. Much attention is paid to the treatment of the underlying disease. The course of treatment is usually at least a month. This is exactly how long it takes to get rid of most sexually transmitted infections. Medicines are administered into the patient’s body for a period of time determined by the doctor, even if the main manifestations of the disease are completely eliminated.

        Ointments, gels, and applications that have an anti-inflammatory effect are used as local remedies in the treatment of infectious joint inflammation. Ultraphonophoresis with hydrocortisone, therapeutic exercises, and taking therapeutic baths help eliminate the main symptoms of the disease.

        Under certain circumstances, treatment for reactive arthritis may take several months. In this case, it is important to re-test the patient’s blood to identify rheumatoid factor in it, which is evidence of another, more dangerous type of disease - rheumatoid arthritis. In very rare cases, with a long course of the disease, drugs such as Sulfasalazine and Methotrexate are prescribed.

        Reactive arthritis - causes, pathogenesis, symptoms, diagnosis and treatment

        Reactive arthritis is one of the fairly common types of arthritis, which is explained by the nature of its occurrence. The disease occurs as a result of inflammation of the so-called synovial membrane of infectious origin and is systemic in nature. At the same time, viable microorganisms are not detected during culture, and this is one of the distinguishing factors in diagnosis.

        The infection can have very different localizations (gastrointestinal tract, genitourinary system, etc.). The manifestation of pathology begins 2-4 weeks after the infection enters the body. Medical practice shows that men are more likely to suffer from reactive arthritis than women.

        Causes of reactive arthritis

        According to long-term studies and observations, the causes of this disease are the presence of enterogenous (localized in the gastrointestinal tract) and urogenital (genitourinary) infections.

        Men who are sexually active are most likely to develop reactive arthritis. The disease can be caused by pathogenic agents such as chlamydia, salmonella, mycoplasma, clostridia and shigella.

        Statistics show that out of 100 people who showed signs of infection in the digestive system, 2-3 people were susceptible to developing reactive arthritis. And in cases of chlamydial infection (damage to the genitourinary system), the development of the disease is observed in 1.5%.

        Also, reactive arthritis can develop due to a genetic predisposition transmitted by certain antigens of the first class of the histocompatibility system. International labeling of these HLA-B27 antigens.

        In most cases, the disease appears between the ages of 20 and 40, regardless of gender. The only peculiarity is the frequency of occurrence of the urogenital form - in men this figure is slightly higher.

        Pathogenesis of reactive arthritis

        The causative agents of urogenital reactive arthritis are Chlamydia trachomatis. When bacteria enter the body, they can parasitize inside cells for a long time without causing appropriate reactions from the immune system. This is explained by their ability to take on an inactive form (the so-called “hibernation period”). However, when the cells in which the bacteria are parasitizing divide, the daughter cells are also affected, and when the bacteria are activated, the affected area will be more extensive.

        The enterogenic form of the disease is caused by bacteria such as Salmonella typhimurium or Enteritidis, Shigella flexneri or sonnei, Yersinia enterocolitica, and Campylobacter jejuni. Typically, such bacteria can enter the human body from large animals (especially if slaughter is carried out incorrectly), as a result of eating contaminated products that have not been properly processed or stored incorrectly, as well as after contact with a carrier.

        Another form of reactive arthritis is the so-called Reiter's syndrome. In this case, a clinical triad of urethritis, conjunctivitis and arthritis is observed. Moreover, the development of these diseases begins after an acute intestinal infection.

        In most cases, the first symptoms of reactive arthritis are recorded 1-2 weeks after the onset of an acute bacterial infection. However, often the first symptoms are recorded only after a month. The first thing you should pay attention to is long-term stiffness in the joints, limiting their mobility. Moreover, the lesion is asymmetrical in nature - usually less than five joints. In most cases, problems occur in the joints of the ankles and knees, although inflammation of the upper extremities also occurs.

        A feature of reactive arthritis is the occurrence of inflammation at the junction of tendons and bones. This inflammation is called enthesitis and is characteristic of the lower extremities. The main manifestation of enthesitis is the occurrence of unpleasant pain in the heels and metatarsal bones. Moreover, if the patient has the HLA-B27 antigen, the risk of developing spondylitis or sacroiliitis increases significantly.

        If a person has suffered an infectious disease, he should know the following symptoms of reactive arthritis:

      • The joints of the toes, knees, hands and wrists become swollen, and a fever may occur.
      • If an infection occurs through the genital tract, the patient feels an increased urge to urinate, a burning sensation in the urinary canal, which is accompanied by various discharges from it.
      • The mucous membrane of the eyes becomes inflamed, which is accompanied by pain, redness and discharge of pus.

    However, a diagnosis cannot be made based on the symptoms listed. The doctor must confirm reactive arthritis by exclusion, as this may be an isolated case of sexually transmitted infection or an inflammatory process of the eyeball.

    Important! Reactive arthritis can develop after vaccination against infections such as measles, viral hepatitis, whooping cough, rubella, diphtheria, mumps. A common cause is tuberculosis.

    Diagnosis of reactive arthritis

    The key to successfully overcoming this disease is early diagnosis, during which a complete medical history is collected. Conducted laboratory tests are usually divided into two groups: primary and secondary. Prescription of treatment is possible only after receiving the results of all studies, otherwise it is almost impossible to achieve the desired result.

    Most people make the mistake of starting to self-medicate. It is very important to entrust the diagnosis to a specialist. The doctor examines the patient and prescribes an individual course of treatment.

    Important! Reactive arthritis should not be confused with rheumatoid arthritis. The difference between the latter is that older people are more likely to suffer from it. Also, its occurrence is not usually associated with infectious diseases.

    The diagnostic procedure involves the following steps:

  • Gathering information based on patient complaints.
  • Examination of the patient.
  • Blood analysis. The doctor measures the level of white blood cells in the blood and the erythrocyte sedimentation rate. With reactive arthritis, these indicators exceed the normal level.
  • Analysis of urine. The leukocyte count is checked.
  • Rheumatic tests. In each case, the doctor decides to conduct the following tests: CRP, total protein, uric acid, etc.
  • A smear of discharge from the urethra. The data is checked for the presence of chlamydia.
  • Stool analysis. In this way, the presence of bacteria such as Shigella, Yersinia or Salmonella is checked.
  • Enzyme immunoassay detects antibodies in joint fluid and blood.
  • The presence of an antigen that is responsible for an autoimmune disease is determined.
  • X-ray.
  • MRI and ultrasound. These laboratory tests are used in complex cases when an x-ray does not provide any information about the disease.
  • Arthroscopy. This method allows you to use equipment to penetrate inside the joint and examine it using a special camera.
  • Depending on the symptoms, each method of diagnosing the patient occurs on an individual basis. Thanks to a number of procedures, it is possible to establish an accurate diagnosis of the disease and a method of treating it. .

    How to treat it correctly

    In most cases, treatment occurs on an outpatient basis. Hospitalization is possible in rare cases of infection of the heart, nervous system and kidneys, when intravenous injection of drugs is required.

    For the treatment process to be effective, complex therapy is necessary, which destroys the microbial infection that caused the disease.

    Important! During pregnancy, you should be especially careful about the treatment of this disease, as some drugs can be dangerous to the fetus.

    There are three main methods of treating reactive arthritis:

  • Antibacterial therapy. The doctor selects antibiotics based on the origin of the disease. He can choose groups of antibiotics such as macrolides, fluoroquinolones and tetracyclines. These products allow you to completely destroy harmful microbes. The main drugs used: Doxycycline, Spiramycin, Ciprofloxacin and Azithromycin.
    1. Anti-inflammatory treatment. The most effective non-steroidal drugs for relieving inflammation are Ibuprofen, Diclofenac and Nimesulide.
    2. There are difficult cases in which the listed medications do not improve the patient’s condition, then hormonal drugs that are injected into the joint come to the rescue. The injection is administered after analyzing the joint fluid for the presence of microbes.

    3. Immunosuppressive therapy. If intra-articular injections of hormones are ineffective, agents are used to suppress the immune response. These drugs include sulfasalazine and methotrexate.
    4. Reactive arthritis is associated with bacteria entering the body. You can avoid an infectious disease by following certain rules:

    5. use protective equipment during sexual intercourse;
    6. maintain hygiene, shower regularly, wash your hands;
    7. give up smoking and alcohol, play sports;
    8. lose excess weight, eat healthy, eat more natural foods (nuts, greens, vegetables, fruits and seafood);
    9. Conduct regular examinations at medical centers.
    10. Now we understand: in order to prevent a terrible disease that prevents you from fully moving and enjoying life, you need to perform a number of simple actions on which the health of the body depends.

      Effective treatment of reactive arthritis with folk remedies

      Reactive arthritis is treated with special medications. However, they additionally use folk remedies that can speed up the healing process.

    11. Cabbage leaf and honey. You will need a fresh cabbage leaf (or several), it needs to be cut so that it can be conveniently applied to the joint. The sheet is heated in a water bath, after which one side is smeared with honey. The honey side should be applied to the sore joint and wrapped in cellophane. This way, the joint will retain heat and absorb nutrients faster. Apply the compress every day before bed, leaving it overnight. After some time, the swelling will go away and the pain will disappear.
    12. A good remedy for arthritis of the knee joint is a compress of horseradish and radish. Both ingredients must be crushed and mixed in equal proportions until a paste is formed. Before applying to the knee, the skin should be lubricated with vegetable oil to avoid irritation.
    13. The most proven remedy for arthritis is sea salt. The salt needs to be heated and poured into a scarf, making a bag out of it, then applied to the sore joint. When the compress has cooled, treat the skin with fir oil (repeat the procedure several times).
    14. There are many plants and herbs that can relieve inflammation and relieve pain, so let’s give an example of the most effective: horseradish, comfrey, radish, tricolor violet, yarrow.

      Decoctions and infusions for oral administration

      The herbs listed above, in addition to the anti-inflammatory effect, can cleanse the body and have a diuretic effect. Herbal decoctions and infusions provide the body with all the necessary minerals and vitamins and promote rapid recovery.

      So, we found out what kind of disease this is - reactive arthritis, what are its symptoms and treatment. And, although it will not be possible to cure it completely, the most important thing is to consult a doctor in time, who will prescribe the necessary drug therapy. However, one should not neglect folk remedies during treatment, because they consist of natural components and, when used wisely, cannot lead to complications.

      Reactive arthritis - symptoms and treatment

      Reactive arthritis (ReA) is an inflammatory lesion of the joints that occurs as a reaction to the invasion of the body by any infectious agents.

      It is important to note that the joint cavity retains its sterility (that is, the inflammation is aseptic).

      The underlying causes of ReA still remain unclear. It is believed that infection plays the role of a trigger, which, in the presence of a genetic predisposition, triggers an immunopathological reaction.

      This disease can be triggered by various bacterial infectious diseases, often infections of the gastrointestinal tract and genitourinary system. In reactive arthritis, which is caused by an infection of the genitourinary system, the initial factor is infections in the urethra, bladder and genitals.

      In cases of infection associated with food poisoning, a condition called enteroarthritis occurs. One to two percent of people who are poisoned by food suffer from the development of an inflammatory process in the joints a few weeks after the poisoning. Hereditary predisposition also plays a role; many people suffering from reactive arthritis have the HLA-B27 gene.

      As already mentioned, reactive arthritis is partly a genetically determined disease. There are certain genetic markers that are much more common in patients with reactive arthritis than in those who have never suffered from the disease. For example, the HLA-B27 gene is often observed in patients with reactive arthritis. But even in patients with a genetic predisposition, reactive arthritis develops only if infected.

      Reactive arthritis can occur after sexually transmitted infections. The most common bacterium that has been associated with this post-venereal form of reactive arthritis is chlamydial infection. It also occurs after infectious dysentery, when infected with bacteria such as Salmonella, Shigella, Yersinia, Campylobacter. Typically, arthritis develops one to three weeks after the bacterial infection appears.

      Reactive arthritis most often affects people aged 20–40 years. Interestingly, after sexually transmitted infections, men get sick nine times more often than women, while after intestinal infections the danger is the same. Men get sick somewhat more severely than women. The risk is increased in individuals with HLA B 27, but testing is not necessary before the disease develops.

      Reactive arthritis in children

      More rare, but still found, is reactive arthritis in children. The disease is no less serious than in adults and can significantly affect the child’s future life, especially when it comes to a future in sports.

      Symptoms in childhood depend on the type of arthritis and age. But the main symptoms can be identified as follows:

    15. Before the immediate manifestation of symptoms of arthritis, the child’s temperature rises, diarrhea occurs, and often runs to the toilet for little reason. These same signs may also indicate an intestinal infection (dysentery, salmonellosis) or infectious problems in the genitourinary system (urethritis, cystitis, chlamydia).
    16. With reactive arthritis in children, predominantly the joints of the legs become inflamed - the ankle, hip or knee joints. The joints noticeably increase in size.
    17. During active physical activity, quite severe pain is felt.
    18. Drowsiness, weakness.
    19. Inflammation of the eyes, tearing, fear of bright light.
    20. If the disease is diagnosed in time, the results of treatment will be positive, and relief from reactive arthritis will occur quite quickly. In addition to antibiotics, anti-inflammatory medications, immunomodulatory drugs, physical therapy and other health procedures are very effective.

      In the first two to four weeks, the patient experiences an intestinal disorder, an acute respiratory infection, or an illness very similar to cystitis in the initial stage.

      Further, the symptoms of reactive arthritis become classic and are conditionally divided into three groups:

    21. the mucous membranes of the eyes become inflamed (conjunctivitis develops) and the eyes themselves;
    22. pain occurs in the joints (their activity is limited, redness and swelling appear);
    23. inflammation develops in the genitourinary area.
    24. In most cases, the initial inflammation occurs in one joint, and only then the disease affects entire joint groups. Clinical manifestations of reactive arthritis vary from transient monoarthritis to fairly severe multisystem disease.

      General symptoms include: weakness, general malaise, increased body temperature. The severity of these manifestations can be either quite insignificant or very strong.

      Polyarthritis or asymmetric oligoarthritis may occur, which predominantly affects the toes or large joints of the lower extremities. In severe cases of the disease, pain in the back is possible.

      In order to understand how to treat reactive arthritis, you need to initially diagnose it correctly. The success of all subsequent treatment will largely depend on the accuracy and timeliness of the diagnosis.

      In the photo you can see the external symptoms of the disease, but otherwise you should consult a doctor if you have the following complaints:

    25. pain in the joints;
    26. the presence of any characteristic infection that appeared several weeks before joint problems;
    27. the problem occurs in no more than 4 - 5 joints at the same time;
    28. there is asymmetry in joint problems;
    29. Most of the problems are with the joints of the legs.
    30. Symptoms are sometimes quite deceptive and similar to other diseases, and therefore it is important for a specialist to apply differential diagnosis.

      Prevention of reactive arthritis comes down to the prevention of infectious diseases: hygiene procedures, proper food preparation, and observing food expiration dates.

      If diseases occur, adequate treatment prescribed by a specialist is necessary. Over the next 1-3 weeks, you should observe a protective regime and avoid re-infection.

      Treatment of reactive arthritis

      In case of diagnosed reactive arthritis, treatment should be carried out by rheumatologists. If it develops in parallel with an acute infectious disease, an infectious disease specialist may become the treating specialist.

      Since the triggering factor for reactive arthritis is usually infection, one of the most important aspects of treatment is to rid the body of these infectious agents. The outcome of the disease will depend on how well this can be done.

      Drug treatment can be divided into several main areas:

    31. elimination of the inflammatory process;
    32. therapy for intestinal or respiratory infections;
    33. chlamydia therapy;
    34. therapy for conjunctivitis in Reiter's syndrome.
    35. Painkillers are also prescribed to relieve joint pain, and in severe cases of the disease, glucocorticoids and immunosuppressants. Treatment of this disease is carried out on an outpatient basis, hospitalization is carried out only in cases where the diagnosis is unclear and constant monitoring is required, as well as in very pronounced manifestations of the disease and a general serious condition.

      For patients who have undergone comprehensive treatment for reactive arthritis, there is the following prognosis for future life:

    36. In 20% of cases, signs of the disease disappear within 6 months;
    37. After properly selected treatment, there is no relapse of the disease;
    38. In 25% of cases, reactive arthritis enters the chronic stage, progressing only in the acute phase;
    39. In 50% of cases, the disease begins to progress with renewed vigor after a certain period of time;
    40. Only in 5% of cases, a severe form of reactive arthritis leads to deformation of the spine and joints.

      It is important to follow a diet. The patient's diet should include natural omega-3 fatty acids, which are rich in sea fish and flaxseed oil. The diet should not contain stimulating, overly spicy and salty foods.

      It has been noted that some vegetables of the nightshade family can cause an exacerbation of the disease and intensify the symptoms of reactive arthritis. Therefore, you should eat potatoes, tomatoes, eggplants and sweet peppers with caution. The diet should be balanced: a low or high calorie diet is not recommended.

      Symptoms, diagnosis and treatment of reactive arthritis of the knee joint

      Among the large number of arthritis, the reactive form of the disease occupies a special place. It is characterized by aseptic inflammation, which asymmetrically affects various joints, skin, mucous membranes, tendons, lymph nodes, nails and is accompanied by systemic reactions. Reactive arthritis of the knee joint (gonarthritis) is quite common, affecting mainly middle-aged people. The disease has a favorable prognosis; with timely treatment, complete recovery is possible.

      According to medical research, the reactive form of gonarthritis occurs among individuals with a genetic predisposition to this pathology. This is the result of excessive activity of the immune system in response to the entry into the body of microbial antigens that circulate in the systemic bloodstream during various diseases. The resulting immune complexes in this form of the disease penetrate into the joint tissues and synovial fluid.

      During research, it was discovered that as a result of the immune response to the entry of antigens of various infectious agents into the body, antibodies are produced and specific immune complexes are formed. They tend to settle in the synovial membranes of the joints and their cavities, provoking the development of immune inflammation. It has been proven that microbial mimicry is of great importance in the development of the disease.

      It lies in a certain similarity between the antigens of infectious agents and the body’s own antigens (HLA B27). The result of this similarity is the production of antibodies not only against a specific pathogen, but also against body cells, which are represented by joint tissues. This leads to the gradual development of inflammation in certain joints (often the knees), which is very typical for this form of the disease.

      The pathogenesis of the development of reactive arthritic inflammation clearly shows that the leading cause of its occurrence is a hereditary predisposition. Thanks to modern research methods, this fact is scientifically substantiated. Laboratory genetic testing reveals the HLA B27 marker, which is associated with the disease.

      The reasons for the development of gonarthritis in a reactive form are as follows:

    41. infectious agents of a viral nature: salmonella, campylobacter, shigella, yersinia;
    42. infectious diseases (dysentery);
    43. diseases in the genitourinary area (ureaplasmosis, chlamydia).
    44. Important! One marker is not enough for the development of arthritis. Only when one of the antigens listed above (salmonella, ureaplasma, etc.) enters the body will an “antigen-antibody” complex be formed. And only if it settles in the joint tissues can we talk about the beginning of the development of the disease.

      Another cause of arthritis is considered to be abnormalities in the structure of the immune system. Any malfunction in its operation can lead to an incorrect response to infectious antigens, which can negatively affect the structure of various tissues of the body, including joints.

      Clinical manifestations

      The course of the reactive form of gonarthritis most often has a classic picture of clinical manifestations, consisting of the following triad of signs:

    45. the occurrence of conjunctivitis;
    46. development of urethritis;
    47. immediate onset of arthritic inflammation.
    48. Symptoms of the disease itself begin to manifest themselves 2 or 4 weeks after the infection (intestinal or sexually transmitted). Initially, signs of urethritis appear, consisting of frequent urination, which is accompanied by a burning sensation and pain. Women may experience vaginal discharge. Then signs of conjunctivitis appear in the form of reddened eyes, a feeling of pain and watery eyes. Most often, all of the listed signs of both diseases are quite weakly expressed.

      Lastly, features of gonarthritis appear, which is reactive in nature and consists of the appearance of edema, arthralgia, local redness of the skin and hyperthermia in the area of ​​the knee joints. The onset of the disease in most cases is acute. Accompanied by high temperature, involvement of articular tissues in pathological processes and a general deterioration in well-being.

      In some cases of the disease, keratoderma occurs, which consists of thickening of the stratum corneum of the epithelium. Sometimes the nails may also suffer, becoming somewhat yellow, often breaking and becoming thicker. Painful ulcers often appear in the oral cavity. There is an increase in peripheral lymph nodes (most often inguinal). In severe cases, even the valve apparatus of the heart is affected. And sometimes diarrhea occurs.

      The swelling of the joints can be so severe that their motor functions suffer. All of these symptoms often appear over a long period of time - from 3 to 12 months. Subsequently, all clinical manifestations of the disease disappear. The main danger of the reactive form of gonarthritis lies in the fact that it has a tendency to recur and become chronic.

      The result of this may be the spread of inflammatory processes to the muscles, tendons and other joints. One of the typical forms of such inflammation is Reiter's disease, which consists of a combination of pathological processes in the area of ​​articular tissues, eyes and genitourinary tract. With late treatment of the disease, there is a risk of deformation of cartilage and bone tissue, as well as the development of cataracts due to uveitis.

      Features of the course in childhood

      According to statistics, the number of reactive gonarthritis in children has increased significantly in recent years. They have exactly the same causes as in adults and affect the right leg or left. In childhood, infectious agents can lead not only to the development of cystitis, urethritis, dysentery or conjunctivitis. A history of the disease may include nephritis and pyelonephritis.

      At the same time, reactive arthritis of the knee joint in children occurs in a more severe form, and in the absence of appropriate therapy, it often leads to various complications. Intense pain occurs in the affected area, movements become constrained. During palpation, the child complains of pain. And the kids stop walking.

      Important! Another feature is that children are not able to localize pain and characterize symptoms. As a result, not particularly attentive parents do not immediately notice changes in the general condition and seek help quite late. And if their diseases are not treated in a timely manner, parents can become a source of infection for their children.

      In addition, the younger the baby, the weaker and more imperfect his immunity is, so he more often suffers from genitourinary, intestinal and other diseases that can lead to gonarthritis in this form. Also, children rarely have the habit of taking care of personal hygiene. Therefore, the role of parents in disease prevention is quite difficult to overestimate.

      Diagnostic principles

      The principles of diagnosing the reactive form of gonarthritis are to identify the following signs of the disease:

      • the appearance of characteristic symptoms after infections in the genitourinary, digestive or respiratory areas (after 2–4 weeks);
      • a combination of damage to the mucous membranes of the eyes, organs of the genitourinary system and arthritis;
      • predominant involvement in the processes of inflammation of the knee joints;
      • asymmetry of the lesion.
      • After identifying all the listed signs of the disease, the next step is to conduct additional studies that will confirm or refute the alleged diagnosis.

        In the reactive form of the disease, an increase in ESR is detected in the peripheral blood. Biochemical analysis shows an increase in C-reactive protein. There is no antinuclear factor and rheumatoid factor. A genetic study reveals the HLA B27 marker. Carrying out ELISA and PCR diagnostics helps to detect the probable causative agent of the disease, as well as smears from the cervical canal and urethra in women and men, respectively.

        Important! The X-ray method of examination for this form of the disease does not have much diagnostic value, but it allows one to identify a number of certain pathological changes in the form of paravertebral ossification and periostitis. Also, this disease usually does not require arthroscopy or puncture of the affected joint.

        To carry out a differential diagnosis of the disease, a culture of the joint fluid is done, in which pathogens are absent. This test allows you to exclude the bacterial form of arthritis. To rule out the rheumatic nature of the disease, you will need to consult a rheumatologist.

        The guiding principle of therapy

        The only and basic principle of treatment for the reactive form of gonarthritis is to eliminate the primary infectious focus, which is located in the intestinal or urogenital tract. For this purpose, the doctor prescribes specific antimicrobial therapy for a period of 4 weeks. Individual selection of the drug and dosage is carried out.

        When a chlamydial form of infection is established, a drug from the group of macrolides, fluoroquinolones or tetracyclines (Sumamed) is prescribed. Sexual partners are subject to mandatory treatment, even if their test results are negative. And in the absence of positive dynamics, drugs of other groups are prescribed.

        Treatment for reactive arthritis of the knee includes:

      • NSAIDs: help eliminate the inflammatory reaction and pain (Indomethacin, Nise);
      • corticosteroids: prescribed systemically or by injection (periarticular or intra-articular), indicated only for severe disease (Prednisolone);
      • Prescription of the drug Sulfalizin: is performed in the event of a persistent form of reactive gonarthritis. Taking the drug is accompanied by a number of side effects and requires laboratory tests after completion of the course of therapy;
      • TNF inhibitors: help cure even resistant forms of the disease and stop the manifestations of arthritis, as well as its accompanying pathologies (spondylitis, uveitis);
      • introduction of stem cells: helps restore damaged cartilage fibers in the area of ​​the knee joint, helps eliminate inflammation and normalize metabolic processes.
      • In case of effusion formation, a puncture of the right or left articular cavity can be performed, which is rarely required for this form of arthritic inflammation. Various anti-inflammatory gels, creams and ointments are prescribed as local therapy, and applications with Dimexide are carried out. A cast or orthosis may be placed to temporarily stabilize the affected area.

        For the treatment of uveitis and conjunctivitis, special eye drops are prescribed. If necessary, an immunologist can prescribe immunomodulatory drugs. Proper nutrition plays an important role in the treatment of the disease. The diet must contain essential fatty acids, which contain flaxseed oil and sea fish in large quantities. You need to eat a balanced diet, consume more vegetables, fruits and dairy products.

        Physiotherapeutic methods for treating the disease include hydrocortisone phonophoresis, cryotherapy, and sinusoidal modulating currents are prescribed. After the end of the acute period of inflammation, a course of physical therapy is carried out and therapeutic baths (hydrogen sulfide, with sea salt) and mud therapy are prescribed. All of these procedures help prevent the further spread of pathological processes and contribute to the reverse development of the disease.

        Alternative medicine methods

        Traditional medicine can help enhance the effect of ongoing treatment measures. It will also be useful for those who have contraindications to certain drugs from traditional medicine or prefer to be treated at home. The main folk methods of treating this form of the disease are compresses, ointments and applications to the area of ​​the diseased joint.

        Important! It is necessary to understand that alternative medicine methods must be combined with the use of official medicines. This is due to the fact that home treatments will not be able to cope with the main cause of the disease - infection.

        As an example, here are some popular recipes:

      • Comfrey ointment. To prepare it you will need a glass of comfrey leaves (or crushed roots), ? a glass of beeswax, an oil solution of vitamin E and a glass of vegetable oil. You need to mix the ingredients and put on low heat. You need to cook for at least half an hour. Then you should strain the broth and add wax minced through a meat grinder and a few drops of vitamin E. The finished ointment should be applied to the sore joint as a compress for one day.
      • Compress of horseradish and black radish. First you need to chop the radish until you get a kind of gruel. It should be applied to the sore spot, having previously lubricated it with vegetable oil or baby cream. Place cotton wool, gauze, plastic wrap and a clean cloth on top. Keep the compress for a couple of hours. The next day you need to make a horseradish compress. As other remedies, you can use compresses with heated sea salt. For this disease, it can also be added to bath water.
      • Complications and prevention

        The most common complications of the reactive form of gonarthritis are: the transition of the disease to a chronic form with periodic exacerbations and impaired mobility in the affected knee. Chronic pain in the affected joint may also occur, and sometimes visual acuity decreases or cataracts occur. In some cases, chronic diseases of internal organs develop: decreased filtration function of the kidneys, amyloidosis, myocarditis, thickening of the pleura in the lungs.

        Therefore, it is so important to monitor your health and prevent disease. As preventive measures for reactive gonarthritis, experts recommend:

      • avoid casual sexual contact to exclude the possibility of contracting urogenital infections (it is best to have a regular sexual partner);
      • timely treatment of genitourinary, intestinal infections and diseases of the throat and nose;
      • practice personal hygiene;
      • adhere to a healthy lifestyle;
      • if possible, eat healthy;
      • Regularly visit medical institutions for medical examinations.
      • Important! In childhood, you should always warn the doctor that the baby has had reactive gonarthritis before vaccination is planned. And parents themselves should undergo regular examinations, since they can be a source of infection for their children.

        A fairly common pathology in middle age is a reactive form of arthritic inflammation in the knee area. It is mainly caused by intestinal or urogenital infections. In recent years, the number of people suffering from this particular form of arthritis has increased significantly, which causes a certain concern among specialists.

        Therefore, they strongly recommend closely monitoring your health and promptly seeking medical help at the very first manifestations of any infection or arthritis itself. Only in this case can the disease be quickly diagnosed and completely cured.

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