Reactive Arthritis (Formerly Reiter's Syndrome)

  • Medical Author:
    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

  • Medical Editor: Jerry R. Balentine, DO, FACEP
    Jerry R. Balentine, DO, FACEP

    Jerry R. Balentine, DO, FACEP

    Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

Symptoms of Rheumatoid Arthritis

How do health-care professionals diagnose reactive arthritis?

There is no single lab test used to diagnose reactive arthritis. Reactive arthritis is diagnosed based upon recognition of the combination of arthritis with inflammation of the eyes, and the genital, urinary, and/or gastrointestinal systems. The doctor obtains a medical history to note the time course of possible infection in the genital or urinary tracts, or the bowel. Stiffness and pain are monitored. Inflammatory types of joint problems typically cause more stiffness in the morning. Blood tests such as a sedimentation rate may be obtained to document the presence of inflammation in the body. The rheumatoid factor, which is typically present in rheumatoid arthritis, is usually negative in reactive arthritis. The HLA-B27 gene marker blood test can be helpful, especially in the diagnosis of patients with spine disease. Other tests may be ordered to eliminate other possible diseases with similar symptoms.

X-rays of the spine or other joints can reveal typical changes of inflammation in these areas but generally not until later in the disease. Occasionally, there are areas of unusual calcifications at the points where the tendons attach to the bones, indicating past inflammation in these areas. Those patients with eye inflammation may require ophthalmology evaluation to document the degree of inflammation in the iris. Stool cultures might be obtained to detect the presence of infections in the bowel. Similarly, urinalysis and culture of the urine may be necessary to detect bacterial infection in the urinary tract. The prostate gland, which can also be inflamed in a patient with reactive arthritis, may be examined for tenderness.

Sometimes the fluid of the inflamed joint needs to be examined. In this case, a doctor will use a needle to withdraw fluid from the joint in sterile fashion. The joint fluid will be examined for white blood cells, bacteria (to check for infection), and crystals (to eliminate gout as a diagnosis).

Medically Reviewed by a Doctor on 12/2/2015

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