Artritis reactiva

Abstract

Reactive arthritis (RA) is a form of aseptic arthritis that usually occurs one to six weeks after a primary infection that did not initially affect the joints. The microorganisms usually involved in its onset tend to have a genitourinary or enteric origin. It usually appears in young patients, with a peak incidence in individuals between 30 and 40 years of age. The natural history of this disease classifies the clinical manifestations according to chronology in an acute phase, in which the symptoms of the primary infection manifest and followed a few days later by joint manifestations, and a chronic phase of disease, if the symptoms persist for more than six months. Symptoms include musculoskeletal manifestations (peripheral and axial arthritis, dactylitis, and enthesitis) and extra-articular manifestations, including mucocutaneous manifestations such as balanitis circinata and keratoderma blennorrhagicum, and ocular manifestations, with conjunctivitis being the most common. The diagnosis should be made by attempting to identify the causative bacteria via culture when possible, serology, or molecular tests such as RCP. Antibiotic therapy should be used to treat the active infection. For joint manifestations, NSAIDs and corticosteroids are the first line of treatment, followed by disease-modifying drugs and anti-TNF-alpha for refractory or chronic cases.