Medicus, Vol. 21 No. 1_UGI, 2012.
Pregledni rad
Reactive Arthritis
Zoja Gnjidić
; Poliklinika za reumatske bolesti, fizikalnu medicinu i rehabilitaciju �Dr. Drago �op�
Sažetak
Reactive arthritis (ReA) belongs to the group of seronegative spondyloarthropathies, and it can be defined as the sterile inflammatory arthritis resulting from the immunomodulatory response to an infection elsewhere in the body. The infection often affects the gastrointestinal system (enteroarthritis) or the urogenital tract (uroarthritis). Diagnosis is based on the detection of the arthritogenic infection and the clinical picture of mono- or oligoarthritis, predominantly affecting lower limbs, which develops 2-4 weeks following an infection somewhere else in the body. Additional symptoms may include inflammatory low back pain and sacroiliitis or spondylitis, and extra-articular findings such as enthesitis, tenosynovitis, bursitis, dactylitis, conjunctivitis, iritis and mucocutaneous lesions. It is predominant in young men. There is no specific treatment. Management aims at eradication of the underlying infection and prevention of the relapse. It is strongly recommended to start antibiotic therapy (co-administration of two antibiotics or monotherapy) and treat the underlying infection as soon as possible. However, there is no evidence about the benefits of antibiotic therapy in enteric-related reactive arthritis or chronic ReA due to any cause. As with any other inflammatory arthritis, therapy management should focus on control or relief of pain, prevention of joint destruction and/or disability. This can be accomplished by nonsteroidal antirheumatic drugs, analgesics, steroids, immunosuppressants, and rest and physical therapy. It is very important that patients have adequate information about their illness. Prognosis is mostly good. Two-thirds of patients develop chronicity or some discomfort after acute ReA. Prognosis is good in the absence of sacroiliac or thoracolumbar changes, in HLA-B27 negative patients and in male patients. Most patients have a normal quality of life.
Ključne riječi
reactive arthritis; clinical presentation; diagnostics; therapy
Hrčak ID:
89363
URI
Datum izdavanja:
23.1.2012.
Posjeta: 11.221 *