Reactive arthritis physical examination

Reactive arthritis Microchapters
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Natural History, Complications and Prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]

Overview

Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].

OR

Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

The presence of [finding(s)] on physical examination is diagnostic of [disease name].

OR

The presence of [finding(s)] on physical examination is highly suggestive of [disease name].

Physical Examination

Physical examination of patients with reactive arthritis is usually remarkable for arthritis, conjunctivitis, and urethritis.

Appearance of the Patient

• Patients with reactive arthritis usually appear fatigued.

Vital Signs

• Low-grade fever

Skin

• Skin examination of patients with reactive arthritis presents with onychodystrophy and keratoderma blennorrhagicum (commonly).

HEENT

• Ophthalmoscopic exam may be abnormal with findings of conjunctivitis.
• As the disease progresses other findings such as scleritis, episcleritis, and corneal ulceration may be present.

Heart

Cardiovascular examination of patients with severe reactive arthritis may have:

• Myocarditis
• Pericarditis
• Aortitis
• Aortic regurgitation
• Transient conduction abnormalities

Abdomen

• Diarrhea
• Abdominal pain

Genitourinary

• Urethritis with erythema, edema and clear mucoid discharge.
• Spread of infection may further lead to prostatitis (males) or cervicitis, cystitis, salpingo-oophoritis and vulvovaginitis (females).
• Circinate balanitis (balanitis circinata)pyelonephritis; bartholinitis
• Bartholinitis

Extremities

Lower extremities (weight bearing joints) are commonly affected in reactive arthritis. Signs include:

• Dactylitis (sausage-shaped finger)
• Enthesopathy
• Sacroiliitis

Physical Examination

There is pain, swelling, redness, and heat in the joints.

Images

• Picture - Conjunctivitis in reactive arthritis (Chlamydia)
• Picture - Psoriasiform skin changes in reactive arthritis (Chlamydia)
• Picture - arm lesions in reactive arthritis (Chlamydia)
• Picture - hand lesions in reactive arthritis (Chlamydia)

Gallery

Skin

Extremities

• 

  Patient’s hands exhibited severe sloughing of the skin, which is a symptom of his diagnosed “Reiter’s syndrome”. From Public Health Image Library (PHIL).

• 

  Patient’s right hand exhibited pustules on the palm and fingers, which is a symptom of his diagnosed “Reiter’s syndrome”. From Public Health Image Library (PHIL).

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

• 

  Reiter's syndrome. Adapted from Dermatology Atlas.

Genitalia

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  Reiter's syndrome. Adapted from Dermatology Atlas.

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  Reiter's syndrome. Adapted from Dermatology Atlas.

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  Reiter's syndrome. Adapted from Dermatology Atlas.

Eye

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  Reiter's syndrome. Adapted from Dermatology Atlas.

References

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