Reactive arthritis

To diagnose reactive arthritis, your healthcare professional starts with a physical exam. They check your joints for swelling, warmth and tenderness. You may have tests to look at how well you can move your spine and affected joints. Your healthcare professional also may look at your eyes for signs of inflammation and examine your skin for rashes.

Blood tests

A blood test can help look for signs that support the diagnosis. Your healthcare professional may check for:

• A current or past infection.
• Inflammation in your body.
• Antibodies that could point to other types of arthritis.
• A genetic marker called HLA-B27 that is sometimes linked to reactive arthritis.

Joint fluid tests

Your healthcare professional may take a small sample of fluid from an affected joint using a needle. This test helps rule out other conditions. The fluid is tested for:

• White blood cells. High levels can mean inflammation or infection.
• Bacteria. The presence of bacteria may mean a joint infection called septic arthritis. This type of infection can cause serious joint damage.
• Crystals. Uric acid crystals may indicate gout, another type of painful arthritis that often affects the big toe.

Imaging tests

X-rays of your low back, pelvis and joints can help show typical signs of reactive arthritis or rule out other forms of arthritis.

The main goals of treatment are to relieve your symptoms and treat any infection that may still be present. Because reactive arthritis may affect different parts of the body, more than one doctor or other healthcare professional may be involved in your care.

Medicines

If your reactive arthritis was caused by a bacterial infection, your healthcare professional may prescribe an antibiotic to treat it. Which antibiotic you take depends on the type of bacteria found.

Symptoms of reactive arthritis may be eased with:

• Nonsteroidal anti-inflammatory drugs (NSAIDs). Prescription NSAIDs, such as indomethacin (Indocin), can relieve the inflammation and pain of reactive arthritis.
• Steroids. A steroid injection into a painful joint can lessen inflammation and help you move more comfortably. Steroid eye drops may help with eye symptoms. Steroid creams can be used for skin rashes. And you may take steroids in pill form.
• Rheumatoid arthritis medicines. For ongoing pain and stiffness, medicines such as sulfasalazine (Azulfidine), methotrexate (Trexall) or etanercept (Enbrel) may be helpful for some people. Etanercept typically is used to treat rheumatoid arthritis.

Physical therapy

A physical therapist can teach you exercises to strengthen the muscles around affected joints and improve flexibility.

• Strengthening exercises support the joints and reduce strain.
• Range-of-motion exercises help you stay flexible and prevent stiffness.

You'll likely start by seeing your primary healthcare professional. They may refer you to a doctor who specializes in arthritis, called a rheumatologist, for further testing or treatment.

What you can do

When you make the appointment, ask if there's anything you need to do in advance, such as fasting before having a specific test.

Make a list of:

• Your symptoms, even ones that don't seem related to the reason you made the appointment.
• Your medical and family history.
• All medicines, vitamins or supplements you take, including doses.
• Questions you want to ask.

Take a family member or friend along, if possible. They can help you remember information and ask questions. Good questions to ask include:

• What is likely causing my symptoms or condition?
• What are other possible causes?
• What tests do I need?
• What treatment approach do you recommend?
• When should I expect to feel better?
• Is there anything I can do to lessen my joint pain now?
• Am I at risk of long-term complications?
• How can I manage this along with my other health conditions?

Don't hesitate to ask about anything else that concerns you.

What to expect from your doctor

Your healthcare professional may ask you questions such as:

• When did your symptoms start?
• Do they come and go, or do they happen all the time?
• How serious is your pain or stiffness?
• What makes your symptoms better or worse?
• Have you had any recent infections?