Reactive arthritis: A Joint pain after dysentery or unprotected sex

Have you ever experienced such type of joints pain? Either after having an episode of dysentery or following sexual activity? Or do you know that painful joints may happen following those conditions? In this short post we are going to know about this.

About 1-4 weeks after gastroenteritis due to certain bacteria such as shigella, salmonella, yersinia or campylobacter a patient may have an acute attack of painful joints predominantly in the lower limbs joints. Beside the joints pain, other important features are conjunctivitis and urethritis. Similarly following a unsafe sexual contact if a person is infected with a bacteria known as chlamydia may have same problems.

It is called reactive arthritis because these features manifest due to post infectious autoimmune reactions. Unlike septic arthritis no bacteria is found in the joint space, hence antibiotics are of no use in reactive arthritis with a few exceptions. In case of dysentery, male and female are equally affected but in case of sexual contact male female ratio is 15:1! By the time joints are involved the primary infection (either gastrointestinal tract or genitourinary tract) may have been subsidised. That's why antibiotics are not given routinely.

Though the triads of arthritis, conjunctivitis and urethritis are invariably present some other skin conditions are associated with reactive arthritis e.g. circinate balanitis, keratoderma blennorrhagica, pustular psoriasis etc.

A picture of keratoderma blennorrhagica in Palm. Image from Google search

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You can just remember the following line which is the take home messages.

A patient with reactive arthritis can't see,can't pee and can't bend the knee.

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