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Friday, February 11, 2011

REITER'S SYNDROME

It is a seronegative arthritis consisting of a traid of
  • Reactive arthritis
  • Nonspecific urethritis and
  • Conjunctivitis
Two types are recognised.

  • Following a gastrointestinal infection (dysentery) with Yersinia, Salmonella or Shigella.
  • Following nonspecific urethritis.
In both cases there is strong association with the presence of HLA 27 or closely related antigens.
Joints of lower limb may be affected in asymmetrical patterns. It may be monoarticular involving knee or hind foot most frequently.
Plantar fascitis and tendinitis around ankle are common cause of pain.
"Dactylitis" (Sausage toe) with diffuse swelling, redness and pain may present.

Other Manifestations
  • Stomatitis
  • Balanitis
  • Keratoderma blennorrhagica
  • Oral ulcers
Medical
  • Acute severe stage- splinting and bedrest.
  • Nonsteroidal anti-inflammatory drugs, intra articular corticosteroids
  • Urethritis- After pain relief by conventional means, affected joints are treated by free exercise to maintain mobility and improve muscle power, Walking aids can be used in the presence of severe pain for weight bearing.

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