REACTIVE ARTHRITIS - IS IT A USEFUL CONCEPT

Reactive arthritis (ReA) is one of the most common arthritides affecti ng young adults. in most cases it follows urogenital or enteric bacter ial infection, but its pathogenesis is not fully understood. It is gen erally considered a sterile arthritis which appears to involve immune response to bacterial organisms and genetic host susceptibility associ ated with the presence of HLA-B27 antigen. New findings suggest that i n some ReA cases, viable bacteria are present inside the joints, and t hese organisms may cause the disease and trigger the inflammatory resp onse. ReA manifests clinically as a rheumatoid factor negative oligoar thritis associated with enthesopathy and certain mucosal and skin lesi ons. Laboratory findings in ReA are non-specific. Although concepts of its pathogenesis are still evolving, so-called ReA remains an importa nt condition to be distinguished from rheumatoid arthritis. Prognosis is generally better. Treatments with known effects in some cases inclu de non-steroidal antiinflammatory drugs, intra-articular corticosteroi ds, oral tetracyclines and sulphasalazine. The occasional chronic and severe ReA may be very difficult to treat.