Wednesday, July 6, 2011

Reactive arthritis - diagnosis

There is no specific test for reactive arthritis, but watching thepeople suspicious:
Recent symptoms of diarrhea, fever, vomiting
-Current medications
-recent infections
-positive family history for the disease.

Is a physical examination of joints, skin, reflexes and muscle strength.

Tests used to diagnose reactive arthritis:
- Radiography of the joints
- Blood tests (rheumatoid factor, HLA-B27 gene, Ac ANA,sedimentation rate)
- Test for Chlamydia
- Joint biopsy.

Prognosis and evolution

Most people with reactive arthritis recover fully and resumeactivities undertaken in six months after first symptoms, which areless severe.

A 20% will develop chronic arthritis, was forced to change hismunca.Studiile showed that between 15 and 50% of patients willhave periods of remission reactivation after entering the firstattack.

All persons with a family history of reactive arthritis should be to protect themselves during sex.

Reactive arthritis - causes

Nobody knows the exact cause of reactive arthritis, digestive tractor is accused urogenital infection. It is probably a genetic component involved.

Urogenital tract infections: infections of the bladder, urethra, orvagina in women are called urogenital reactive arthritis.

Reactive arthritis usually occurs one to three weeks after infection.The infection is transmitted sexually and is incriminated bacteriaChlamydia and Neisseria trahomatis gonorrheae. And Chlamydiapneumoniae pneumonia.

Another form of reactive arthritis is the gastrointestinal: Salmonella,Shigella, Yerssinia, Campylobacter.
People can become infected with these bacteria after eating orpreparing food incorrectly, such as meat at a suitable temperaturenedepozitata.

Genetics: genetic variation was identified HLA-B27, that increasesa person's risk of developing boala.Aproximativ 80% of patientshave this gene, though its presence does not guarantee diseaseonset.

Reactive arthritis - treatment

There is no cure for this disease is just trying to improvesymptoms.

Medications include:
-NSAIDs NSAIDs
-steroids
-antibiotics
immunosuppressive drug-
TNF-inhibitors.

NSAIDs reduce inflammation and reduce pain:
-indomethacin
-tolmetin.

It is not clear whether a new class of NSAIDs called COX-2inhibitors have an effect on disease: celecoxib.
Although NSAIDs are useful in pain control, not eliminate themtotally. Some people do not respond at all to therapy.

Corticosteroid injections directly into the swollen joint can reduceinflamatia.Acestea are usually prescribed after failure areAINS.Corticosteroizii topical creams or lotions and can be applied directly to skin lesions, such as reducing inflammation and speed healing ulcerele.Acestia.
Antibiotics are given to eradicate the infection that triggeredboala.Antibioticul prescribed depends on the type of bacteria. For example, Chlamydia using doxiciclina.Terapia lasts seven days or more, up to three months.

Immunosuppressive drugs are necessary in patients with severesymptoms that can not be controlled by other therapies, examples:
-Methotrexate
-sulfasalazine.
TNF inhibitors include:
-etanercept
-infliximab
-adalimumab.

Physical exercise helps introduced gradually, maintaining jointfunction. They aim to improve stiffness, strengthen muscles andincrease flexibility.
For successful treatment requires a team of specialists and notone doctor, it should include:
-eye
-gynecologist
-urologist
-dermatologist
, orthopedist.

Reactive arthritis - Symptoms

Symptoms typically occur at one, two weeks after urogenital infection or severe gastrointestinala.Cit it depends on the body will be sick. Can occur only mild pain and increase in volume of the joints or in severe cases and other organs.
Common areas affected are:-JointsUrogenital tract,-Eyes.
Also patients may have:-Fever-Tiredness-Muscle pain-Weight loss.
Rare symptoms are mouth ulcers and skin rash.They persist for a period of several weeks up to several months.
Joints: reactive arthritis involves pain and swelling of one or more joints (knees, heels, ankle). Wrist, fingers and other joints are affected more classic sign rar.Un sausage finger, it refers to swelling of one finger (this is common in psoriatic arthritis).People with reactive arthritis develop tendinitis (inflammation of tendons), or entezite (inflammation of the tendon insertion site on the bone). Thus Achilles tendon pain occurs behind the heel.Calcanieni spurs may occur, ie the heel bone growths that cause pain sufferers cronica.Aproximativ half of back and buttock pain.Ankylosing cause reactive arthritis (inflammation of the vertebrae) or sacroileita (inflammation of the joints of the spine and sacrum).These people may have back pain and neck.
Urogenital tract: infection include the urethra, bladder, prostate, uterus and vaginul.Barbatii may:-The need to urinate-Burning sensation when urinating-Penile discharge.
Prostatitis (inflammation of the prostate gland), the symptoms include fever and chills, and repeated need to urinate, along with a burning sensation.
Women can cervicitis (inflammation of the cervix) or urethritis, which causes burning sensation when urinating. In addition, some women may develop salpingitis (inflammation of the fallopian tube) or vulvo.
Eyes: reactive arthritis causes inflammation of parts of the eye (uveitis and conjunctivitis). This causes:Eye-redness-Pain-Blurred vision.Uveitis may not respond to treatment, leading to vision loss.
Other rare symptoms: almost 40% of sufferers small ulcers, painful on the glans small percentage of patients develop penisului.Un nodules in the palm or reactive arthritis talpa.In rare cause heart damage, nervous system or lungs.