As always, this is from the ever expanding google doc on bits and bobs I read and learn from and transfer here for all our learning pleasure.
- You probably used to know this as Reiter’s Syndrome (at least it was when I went to medical school) but it has gone the way of Wegener’s and had its name changed due to the Nazi associations.
- usually 2-6 weeks following infection
- GU or enteric infections
- GU: chlamidiya (remember chlamidiya less likely to have urethritis symptoms than gonococcal)
- Enteric: Salmonella, Shigella, Yersinia, or Campylobacter
- both have asymmetric arthritis, knees, ankles feet and heels most often involved.
- can also have conjunctivitis and even uveitis
- up to 10% can have painless ulcers of mouth and tongue which can later become painful shallow ulcers, penis can also be involved.
- look for dactylitis (remember this also occurs in psoriatic arthritis)
- NSAIDS work well for both
- antibiotics work for chlamidiya associated cases but not enteric ones
- gonocoocal arthritis the most common cause of septic arthritis in sexually active population
- more females than males
- does not present the same as classic septic arthritis and much less chance of joint destruction
- can be split into two syndromes that overlap
- oligoarthritis (usually a couple of joints rather than just one).
- disseminated gonococcal infection syndrome (migratory polyarthalgias, skin lesions, tenosynovitis)
- very difficult to grow GC from a joint, but other cultures may well be +ve (e.g. pharyngeal or genital)
- admission for treatment (ceftriaxone IV/IM daily) recommended
- Rosen’s 8th Chapter 116
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