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Reiter’s Syndrome and Reactive Arthritis – What to Know

Reviewed by
Dr. Kyle Scholnick

The term Reiter’s syndrome refers to a specific type of reactive arthritis, a condition in which the joints—most often the knees, ankles, and foot joints—experience swelling and inflammation resulting from an infection elsewhere in the body (usually the genitals or intestines).

These conditions most often result from sexual activity or food poisoning.

Symptoms of Reiter’s Syndrome and Reactive Arthritis

Most forms of reactive arthritis are characterized by pain, swelling, and inflammation in the toes and in the joints of the foot, ankle, and knees. There is also commonly heel pain or Achilles tendon pain.

With Reiter’s syndrome, the eyes and urethra are also affected, and symptoms may include conjunctivitis (pink eye), uveitis (eye inflammation), iritis (inflammation of the iris), pain or burning with urination.

In addition to joint pain in the foot and ankle, people suffering from Reiter’s syndrome may also have nodules or pus-filled sores on the soles of their feet and on the toes.

The unique way in which Reiter’s syndrome affects the eyes, the urinary tract, and the feet is summarized in a mnemonic device of unknown age and origin: “Can’t see, can’t pee, can’t climb a tree.”

The initial infection that brings on a case of reactive arthritis may present itself in the form of diarrhea or other gastric distress—especially if the infection was acquired through food poisoning—but in some cases there are no symptoms until the reactive arthritis begins to affect the ankles or other joints.

Causes and Risk Factors of Reiter’s Syndrome To Know About

Reactive arthritis is more commonly seen in white males between the ages of 20 and 40 than in any other demographic group, and women tend to experience milder symptoms than men.

Men and women are equally likely to develop reactive arthritis after contracting food poisoning, but men are more likely to develop it in response to sexually transmitted infections.

The bacterial infections that most commonly trigger Reiter’s syndrome are sexually transmitted infections such as chlamydia and food-borne bacteria such as salmonella, yersinia, and shigella. However, not everyone who is exposed to these bacteria becomes afflicted with reactive arthritis.

It is believed that there is also a genetic component to reactive arthritis, and that certain people are genetically predisposed to be susceptible to these conditions.

About 80 percent of people who suffer from Reiter’s syndrome are carriers of the HLA-B27 gene, which is also common among people who suffer from other types of reactive arthritis.

Correlation does not equal causation, however, and it is important to remember that it is possible to contract this condition even if you are not a carrier of the HLA-B27 gene. A family history that includes any type of reactive arthritis is also cause for concern.

Reactive arthritis is thought to be an autoimmune condition. Triggered by the infection, the immune system overreacts and begins to attack the body’s own tissues, causing pain and inflammation.

Diagnosing Reiter’s Syndrome – What to Expect at Your Doctor’s Office

If your doctor suspects Reiter’s syndrome or some other form of reactive arthritis, he or she will probably want to take a blood sample to test for the presence of infection or evidence of infection in the recent past.

Genetic testing may also be conducted to determine whether you are a carrier of the HLA-B27 gene.

Your doctor may also take a sample of your joint fluid to look for uric acid crystals (which might indicate that the problem is gout), bacterial infection in the joint (i.e., septic arthritis), or an elevated white blood cell count (which may also indicate infection).

How is Reiter’s Syndrome Treated?

Unfortunately, there is no cure for Reiter’s syndrome, but in its early stages the symptoms can be managed with nonsteroidal anti-inflammatory drugs (NSAIDs), which reduce inflammation and alleviate pain. Ibuprofen (e.g., Motrin or Advil) is often used for this purpose.

As with other forms of arthritis, physical therapy can help to improve joint function and alleviate stiffness.

In severe cases, corticosteroids may be injected directly into the affected joint(s), and drugs such as sulfasalazine or methotrexate may be prescribed to suppress the activity of the immune system.

Another measure that may be taken in severe cases is the use of tumor necrosis factor (TNF) inhibitors. These drugs block the action of a protein that is responsible for causing inflammation.

TNF inhibitors are also sometimes used to treat the symptoms of rheumatoid arthritis. X-rays of your joints may also be taken to rule out other types of arthritis or other causes of joint pain.

Can Reiter’s Syndrome Be Prevented?

The only way to prevent Reiter’s syndrome or other forms of reactive arthritis is to avoid the kinds of infections that can cause these conditions.

While there is no way to guarantee with 100 percent certainty that you will not contract such an infection, you can improve your chances by not having unprotected sex with someone who may have a sexually transmitted disease (in principle, this means anyone not personally known to you), and by not eating at restaurants that have not been properly inspected by local health authorities.

It is also important to make sure the food in your home is stored at a sufficiently low temperature to properly preserve its freshness, and that it is cooked thoroughly before it is eaten.

What Is The Prognosis of Reiter’s Syndrome?

Although Reiter’s syndrome cannot be cured, symptoms will resolve on their own in most cases, usually within a year, and sometimes within a matter of months, or even weeks.

Medical References:

    The Mayo Clinic Spondylitis Association of America The American College of Rheumatology National Institutes of Health University of Maryland Medical System Mark A. Marinella (1 September 2001). Recognizing Clinical Patterns: Clues to a Timely Diagnosis. Hanley & Belfus. p. 44

This page was last updated on October 1st, 2015

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