(GP)

Overview

• Sterile arthritis that occurs after a bacterial infection of the gastrointestinal or urinary tract
  • Post-STI form (much more common in men) ⇒ due to Chlamydia trachomatis
• Categorised as a Seronegative Spondyloarthropathy → negative for rheumatoid factor and has a strong genetic association with HLA-B27
• Commonly affects young men

Making Diagnosis

Clinical Features:

• Arthritis → clinical symptoms develop 1-4 weeks after onset of infection. Usually larger joints in lower extremity. Inflammation leads to painful, swollen, warm, red and stiff joints (normal ROM unlike septic), especially in morning. Swelling of digits. May also get lower back pain.
• Conjunctivitis or Uveitis
• Symptoms from preceding infection → diarrhoea, dysuria, urethritis
• Dactylitis → inflammation of digit (finger or toe)
• Constitutional Symptoms → fever, fatigue, weight loss

<aside> 💡 Can’t see, can’t pee, can’t climb a tree

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Investigations:

• ESR & CRP → elevated