What is reactive arthritis

Today, signs of joint disease acquired epidemic. Every third Mrs.Tel planet sooner or later confronted with arthritis or osteoarthritis, but not everyone knows. Today we will try to tell you about the 1st disease, namely its varieties such as reactive arthritis and its variants.

And so, reactive arthritis - a disease with aseptic inflammationm joint, occurs in response to infection ekstraartikulyarnu transferred, with the primary infectious agent is not released from the synovial fluid using standard artificial culture media.

The need for awareness of doctors on this disease is primarily due to considerabletive incidence of reactive arthritis in the structure of rheumatic diseases in children and the need for differential diagnosis with this serious pathology, as septic arthritis, acute rheumatic fever, systemic inflammatory connective tissue disease and juvenile rheumatoid arthritis (JRA).

Terminology

Currently, the two terms are used: « reactive arthropathy » and « reactive arthritis & raquo ;. « Arthropathy » It is « secondary joint damage compared to other diseases and conditions & raquo ;. « Arthritis » It can be defined as Artropatiyu inflammatory genesis. Since the clinical arthritis is most often seen synovitis (inflammation of the synovial membrane with the exhaust into the joint cavity ± synovial hypertrophy), usually diagnosis is established if there is swelling in the joints, pain « start » nature and morning stiffness.

However, in children Inflammation of the joints can occur with severe mismatch pain to objective changes in them (so-called « dry » joint) or go only arthralgia, especially in HLA-B27-positive children. In this case, the term « Arthritis » better to replace the term « ArthroPatiala & raquo ;. The ICD-10 is incorporated, the term « reactive arthropathy & raquo ;. However, in the terminology of rheumatology and research have traditionally used the term « reactive arthritis & raquo ;, so in the future we will take this term, whereas in clinical practice physicians according to ICD-10 is more appropriate tiredpour diagnosis « reactive arthropathy ».

Arthritis associated with infection

All cases of arthritis associated with infection, divided into three groups:

• septic;
• parainfektsiynie;
• post-infectious.

When septic arthritis in fact the infectious agent has a direct damaging effect in the joint. As a rule, this concerns the bacterial pathogens that cause pusarthritis (pioartrit), falling through hematogenous or by draining the osteomyelitis in the joint cavity. This kind of arthritis is « explosive » clinic and in the case of delayed treatment leads to joint destruction.

Parainfektsiynim is artrit , which develops, usually on the background of a viral infection and is accompanied by alteration of joint tissue virus is « sluggish » course and pass a recovery from the underlying disease.

Group postinfectious arthritis uppathological states in which arthritis occurs some time after suffering an infectious process associated with the destruction of immune mechanisms, and / or indirect action of the metabolic products of microorganisms on the joint. Classic examples of postinfectious arthritis is acute rheumatic fever and reagentnye arthritis.

Conclusion

The term « reactive arthritis » Today is used to refer only to cases of postinfectious arthritis that occur as a result of previous infection caused by Salmonella, Shigella, Campylobacter, Yersinia, Chlamydia trachomatis, Ureaplasma urealyticum, β -hemolytic group A streptococcus, Chlamydophila pneumoniae and Mycoplasma pneumoniae. It should be the allocation of « reactive » postinfectious arthritis from the group, due to the high rate of carriers of the antigen HLA-B27 in this subgroup of patients, a risk factor for recurrent joint inflammation or developmentI entezitasotsiyovanoi form of JRA.

From the group of reactive arthritis Reiter's syndrome separately recovered. It is characterized by a combination of the classic triad of asymmetric oligoarthritis, conjunctivitis, urethritis / cervicitis and sometimes the fourth feature - keratoderma and / or psoriasis-like skin rash palms and soles. The disease develops after a chlamydial or intestinal infections and often have recurrent or chronic. Arthritis in Reiter's disease is characterized by a large number of exhaust in the affected joints with little pain and stiffness in them. In children, the disease is extremely rare.