About urethro-oculo-articular syndrome
What is urethro-oculo-articular syndrome?
Reactive arthritis is a general term for a form of joint inflammation (arthritis) that develops as a "reaction" to an infection in another area of the body (i.e., outside of the joints). Joint inflammation is characterized by redness, swelling, pain and warmth in and around the affected joint. In reactive arthritis, the large joints of the lower limbs and the sacroiliac joints are most often affected. Two other common symptoms of reactive arthritis are inflammation of the urinary tract and inflammation of the membrane (conjunctiva) that lines the eyelids (conjunctivitis). These three characteristic symptoms may occur separately, all at once or not at all. Additional symptoms such as fever, weight loss, lower back pain and heel pain may also occur. Reactive arthritis usually develops following a bout with certain bacterial infections including Chlamydia, Salmonella, Shigella, Yersinia, and Campylobacter.
Reactive arthritis belongs to a group of related disorders known as the spondyloarthropathies. These disorders are linked by the association of similar symptoms and a specific genetic marker called HLA-B27. Symptoms common to these disorders include arthritis, especially of the lower limbs, lower back pain and enthesitis, a condition characterized by inflammation at the spot where skeletal muscle attaches to bone. This group of disorders includes reactive arthritis, ankylosing spondylitis, psoriatic arthritis, undifferentiated spondyloarthritis and spondyloarthritis associated with inflammatory bowel disease.
Reactive arthritis is a poorly defined disorder that has been described in the medical literature under many different names. No precise diagnostic or classification criteria have been developed that are universally agreed upon in the medical community.
What are the symptoms for urethro-oculo-articular syndrome?
The first symptoms of reactive Arthritis are painful urination and a discharge from the penis if there is inflammation of the urethra. Diarrhea may occur if the intestines are affected. This is then followed by Arthritis four to 28 days later that usually affects the fingers, toes, ankles, hips, and knee joints. Typically, only one or a few of these joints may be affected at one time. Other symptoms include:
- Mouth ulcers
- Inflammation of the eye
- Keratoderma blennorrhagica (patches of scaly skin on the palms, soles, trunk, or scalp)
- Back pain from sacroiliac (SI) joint involvement
- Pain from inflammation of the ligaments and tendons at the sites of their insertion into the bone (enthesitis)
What are the causes for urethro-oculo-articular syndrome?
The cause of reactive arthritis is still unknown, but research suggests the disease is caused, in part, by a genetic predisposition: Approximately 75% of those with the condition have a positive blood test for the genetic marker HLA-B27.
In sexually active males, most cases of reactive arthritis follow infection with Chlamydia trachomatis or Ureaplasma urealyticum, both sexually transmitted diseases. In other cases, people develop the symptoms following an intestinal infection with shigella, salmonella, yersinia, or campylobacter bacteria.
Besides using condoms during sexual activity, there is no known preventative measure for reactive arthritis.
What are the treatments for urethro-oculo-articular syndrome?
Bacterial infections, such as chlamydia, will need to be treated with antibiotics. Joint inflammation from reactive arthritis is usually treated with nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen, aspirin, or ibuprofen. Skin eruptions and eye inflammation can be treated with steroids.
Those with chronic disease may be prescribed other medications, including methotrexate. Patients with chronic arthritis also may be referred to a physical therapist and may be advised to exercise regularly.
What are the risk factors for urethro-oculo-articular syndrome?
Reactive arthritis primarily affects sexually active males between the ages of 20 and 40. Those with HIV (human immunodeficiency virus) are at a particularly high risk.
Is there a cure/medications for urethro-oculo-articular syndrome?
The prognosis for reactive arthritis varies. Most people recover in three to four months, but about half have recurrences for several years. Some people develop complications that may include inflammation of the heart muscle, inflammation with stiffening of the spine, glaucoma, progressive blindness, feet abnormalities, or accumulation of fluid in the lungs.