Reactive Arthritis in Emergency Medicine Treatment & Management

  • Author: Bo Burns, DO, FACEP, FAAEM; Chief Editor: Robert E O'Connor, MD, MPH   more...
 
Updated: Feb 1, 2010
 

Emergency Department Care

  • Treatment of reactive arthritis is based on symptoms.
  • Physical therapy may be indicated during the recovery phase.
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Consultations

  • Consult a rheumatologist to discuss appropriate additional tests and medications for symptomatic relief or microbiologic cure and to ensure follow-up treatment.
  • Cardiology consultation is necessary in cases of poststreptococcal reactive arthritis as serial echocardiogram and long-term antibiotic therapy may be of benefit to the patient. It is important to remember patients with reactive arthritic symptoms that have evidence of preceding streptococcal infection likely meet the Jones criteria for acute rheumatic fever. Many cardiologists have elected to place these patients on long-term penicillin treatment.[17, 18]
  • Consider an infectious disease (ID) consultation for consideration of empiric antibiotic therapy as well as for patients with coincident manifestations of coincident AIDS-defining illnesses.
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Contributor Information and Disclosures
Author

Bo Burns, DO, FACEP, FAAEM  Assistant Professor, Associate Residency Director, Medical Clerkship Director, Department of Emergency Medicine, University of Oklahoma School of Community Medicine; Attending Physician, Department of Emergency Medicine

Bo Burns, DO, FACEP, FAAEM, is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Charles E Soliman, MD  Resident Physician, Department of Emergency Medicine, University of Oklahoma School of Community Medicine, Tulsa

Disclosure: Nothing to disclose.

Specialty Editor Board

Dana A Stearns, MD  Assistant Director of Undergraduate Education, Department of Emergency Medicine, Massachusetts General Hospital

Dana A Stearns, MD is a member of the following medical societies: American Academy of Emergency Medicine and American College of Emergency Physicians

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Gino A Farina, MD, FACEP, FAAEM  Associate Professor of Clinical Emergency Medicine, Albert Einstein College of Medicine; Program Director, Department of Emergency Medicine, Long Island Jewish Medical Center

Gino A Farina, MD, FACEP, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Robert E O'Connor, MD, MPH  Professor and Chair, Department of Emergency Medicine, University of Virginia Health System

Robert E O'Connor, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Physician Executives, American Heart Association, American Medical Association, Medical Society of Delaware, National Association of EMS Physicians, Society for Academic Emergency Medicine, and Wilderness Medical Society

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors, Thomas Scoggins, MD, and Igor Boyarsky, DO, to the development and writing of this article.

References

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Circinate balanitis in a patient with reactive arthritis.
Plaques on the soles of a patient with reactive arthritis.
Painful erosions on the fingers in a patient with reactive arthritis.
Plaques and erosions of the tongue in a patient with reactive arthritis.
Radiograph of the feet in a 27-year-old man shows erosions in all the left metatarsophalangeal (MTP) joints with subluxation and valgus deformity of most of the toes. Smaller erosions in the four and fifth MTP joints of the right foot are also shown.
Lateral radiograph of the foot (same patient as in the photo above) reveals a calcaneal spur and enthesitis.
Radiograph of both hands shows small erosive changes in both first metacarpal heads associated with minimal subluxation. Bone density is normal.
Radiography of the pelvis reveals bilateral asymmetric sacroiliitis.
Image in 40-year-old man with nonmarginal syndesmophytes predominantly in the lower thoracic and upper lumbar spine.
 
 
 
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