Tests for Reactive Arthritis

Don Jayric V. Depalobos

Mayene Echave

Tests for Reactive Arthritis

Physical Examination
Diagnostic Criteria
Synovial Fluid Analysis
Radiography

Test for Reactive Arthritis

History
> Antecedent infection (1-4 weeks)
Physical Examination
a. Constitutional symptoms: fatigue, malaise, fever, and weight
loss.
b. Musculoskeletal symptoms: acute, assymetric, additive, painful,
dactylitis, entheses.
c. Urogenital lesions
d. Ocular disease
e. Mucocutaneous lesions

 Diagnostic Criteria of the Third International

Workshop on Reactive Arthritis. [Evidencebased]
1. The arthritis should predominantly involve the lower limb,
involve one or a few joints and not equally involve both
sides of the body. (Asymmetric)
2. There should be evidence or a history of preceding infection.
3. If no clear clinical infection, then laboratory confirmation is
essential.
4. No evidence of joint infection. Causes of monoarthritis or
oligoarthritis should be ruled out.

Tests for Reactive Arthritis

Synovial Fluid Analysis
Expected Result:
Non-specifically Inflammatory
Synovial Fluid Analysis is also used to exclude
septic or crystal-induced arthritis.

Tests for Reactive Arthritis

Synovial Fluid Analysis

Tests for Reactive Arthritis

Radiography
Early or mild disease:
>radiographic changes may be absent or confined to juxtaarticular osteoporosis.
With long-standing persistent disease,
>marginal erosions and loss of joint space can be seen in affected joints.
Periostitis with reactive new bone formation is characteristic, as in all the SpA.
Spurs at the insertion of the plantar fascia are common.
Sacroiliitis and spondylitis may be seen as late sequelae. Sacroiliitis is more commonly asymmetric
than in AS, and spondylitis, rather than ascending symmetrically, can begin anywhere along the
lumbar spine.
The syndesmophytes may be asymmetric, coarse and nonmarginal, arising from the middle of a
vertebral body, a pattern less commonly seen in primary AS. Progression to spinal fusion is
uncommon.

References
1. Harrisons Principle of Internal Medicine, 18th
Edition
2. Henry's Clinical Diagnosis and Management by
Laboratory Methods, 22nd Edition
3. Third and Fourth International Workshop on
Reactive Arthritis American Journal of
Rheumatology, American College of
Rheumatology