Overview

Reactive arthritis is joint pain and swelling triggered by an infection in another part of your body — most often your intestines, genitals or urinary tract.

Reactive arthritis usually targets your knees and the joints of your ankles and feet. Inflammation also can affect your eyes, skin and urethra.

Previously, reactive arthritis was sometimes called Reiter's syndrome, which was characterized by eye, urethra and joint inflammation.

Reactive arthritis isn't common. For most people, signs and symptoms come and go, eventually disappearing within 12 months.

Symptoms

The signs and symptoms of reactive arthritis generally start one to four weeks after exposure to a triggering infection. They might include:

  • Pain and stiffness. The joint pain associated with reactive arthritis most commonly occurs in your knees, ankles and feet. You also might have pain in your heels, low back or buttocks.
  • Eye inflammation. Many people who have reactive arthritis also develop eye inflammation (conjunctivitis).
  • Urinary problems. Increased frequency and discomfort during urination may occur, as can inflammation of the prostate gland or cervix.
  • Inflammation of soft tissue where it enters bone (enthesitis). This might include muscles, tendons and ligaments.
  • Swollen toes or fingers. In some cases, your toes or fingers might become so swollen that they resemble sausages.
  • Skin problems. Reactive arthritis can affect your skin a variety of ways, including a rash on your soles and palms and mouth sores.
  • Low back pain. The pain tends to be worse at night or in the morning.

When to see a doctor

If you develop joint pain within a month of having diarrhea or a genital infection, contact your doctor.

Causes

Reactive arthritis develops in reaction to an infection in your body, often in your intestines, genitals or urinary tract. You might not be aware of the triggering infection if it causes mild symptoms or none at all.

Numerous bacteria can cause reactive arthritis. Some are transmitted sexually, and others are foodborne. The most common ones include:

  • Chlamydia
  • Salmonella
  • Shigella
  • Yersinia
  • Campylobacter
  • Clostridium difficile

Reactive arthritis isn't contagious. However, the bacteria that cause it can be transmitted sexually or in contaminated food. Only a few of the people who are exposed to these bacteria develop reactive arthritis.

Risk factors

Certain factors increase your risk of reactive arthritis:

  • Age. Reactive arthritis occurs most frequently in adults between the ages of 20 and 40.
  • Sex. Women and men are equally likely to develop reactive arthritis in response to foodborne infections. However, men are more likely than are women to develop reactive arthritis in response to sexually transmitted bacteria.
  • Hereditary factors. A specific genetic marker has been linked to reactive arthritis. But many people who have this marker never develop the condition.

Prevention

Genetic factors appear to play a role in whether you're likely to develop reactive arthritis. Though you can't change your genetic makeup, you can reduce your exposure to the bacteria that may lead to reactive arthritis.

Make sure your food is stored at proper temperatures and is cooked properly to help you avoid the many foodborne bacteria that can cause reactive arthritis, including salmonella, shigella, yersinia and campylobacter. Some sexually transmitted infections can trigger reactive arthritis. Using condoms might lower your risk.

Nov. 17, 2016
References
  1. Reactive arthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/health_info/Reactive_Arthritis/default.asp. Accessed Sept. 27, 2016.
  2. Yu DT. Reactive arthritis. http://www.uptodate.com/home. Accessed Sept. 27, 2016.
  3. Reactive arthritis. American College of Rheumatology. http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Reactive-Arthritis. Accessed Sept. 27, 2016.
  4. What is reactive arthritis? Arthritis Foundation. http://www.arthritis.org/about-arthritis/types/reactive-arthritis/. Accessed Sept. 27, 2016.