Introduction to reactive arthritis

Kwiatkowska, 2009Zochling, 2010

Reactive arthritis is an inflammatory, postinfective disease that typically presents 1 to 3 weeks after an infection. It has an annual incidence of about 30 per 100 000 people. Reactive arthritis following genitourinary infection occurs predominantly in males, most commonly between 20 and 40 years of age. The most common genitourinary pathogen associated with reactive arthritis is Chlamydia trachomatis. Reactive arthritis following gastrointestinal infection affects males and females equally; the most common enteric pathogens are Salmonella typhimurium, Shigella flexneri, Yersinia enterocolitica and Campylobacter jejuni.

In some people, a history of triggering infection may be absent, but a diagnosis of reactive arthritis can still be made based on clinical presentation.

In up to 80% of people with reactive arthritis, the arthropathy settles within 6 months (acute reactive arthritis), while the remaining 20% have chronic reactive arthritis. Some people will experience recurrent episodes of acute reactive arthritis, which should be managed as acute reactive arthritis.

This topic addresses reactive arthritis in adults; for reactive arthritis in children and adolescents, seek expert advice.

For general information on the spectrum of spondyloarthritis diseases, see Overview of spondyloarthritis.