Hello and welcome to the zero to finals podcast.

My name is Tom and in this episode I'm going to be talking to you about reactive arthritis.

And you can find written notes on this topic at zero to finals.com slash reactive arthritis

or in the rheumatology section of the second edition of the zero to finals medicine book.

So let's get straight into it.

Reactive arthritis involves synovitis or inflammation of the synovial membrane in one or more

joints in response to an infective trigger. Typically it causes acute

monoarthritis affecting one joint, most often the knee, and it presents with a warm, swollen,

and painful joint. A significant differential diagnosis is septic arthritis where there's an infection inside the joint.

Patients with reactive arthritis do not have an infection in the joint.

The most common triggers for reactive arthritis are gastroenteritis or sexually transmitted infections.

Chlamydia may cause reactive arthritis.

Gonorrhea typically causes septic arthritis rather than reactive arthritis.

Reactive arthritis is a seronegative spondolo arthropathy.

There's a link with the HLAB27 gene. It's more common in

patients with HIV and HIV needs to be excluded in patients who present with reactive arthritis.

Let's go through the associations. Reactive arthritis is associated with bilateral conjunctivitis

affecting the eyes, and this is non-infective conjunctivitis, anterior uveitis, which also affects the eyes,

urethritis, which is inflammation of the urethra, and this is non-gonococcal, meaning it's not caused by gonorrhea,

and circinate balanitis, which is dermatitis to the head of the penis.

A tom tip for you, the classic triad of conjunctivitis, urethritis and arthritis are remembered with the

mnemonic can't see, p or climber tree.

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