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Reactive Arthritis

Expert diagnosis and personalized treatment at Arthritis Care of Los Angeles.

What is Reactive Arthritis?

Reactive arthritis is a type of inflammatory arthritis that develops in response to an infection in another part of the body, most commonly the urinary tract, intestines, or genitals. Formerly known as Reiter's syndrome, reactive arthritis causes joint pain and swelling that typically appears within two to four weeks after the triggering infection. The condition most often affects the knees, ankles, and feet, but can involve other joints as well. In addition to joint inflammation, reactive arthritis can cause inflammation of the eyes (conjunctivitis or uveitis), urinary tract symptoms, and skin changes such as mouth sores or a rash on the palms or soles. The classic triad of joint, eye, and urinary symptoms helps distinguish reactive arthritis from other forms of arthritis, although not all patients develop all three features. Dr. Forouzesh at Arthritis Care of Los Angeles provides expert diagnosis and treatment of reactive arthritis at our Culver City and Encino offices. Most cases of reactive arthritis are self-limiting and resolve within several months, but some patients develop chronic symptoms that require ongoing rheumatologic care.

Common Symptoms

  • Joint pain, swelling, and stiffness, especially in the knees, ankles, and feet
  • Pain at tendon and ligament attachment points (enthesitis), particularly the Achilles tendon
  • Red, irritated eyes (conjunctivitis) or more serious eye inflammation (uveitis)
  • Painful or frequent urination
  • Lower back and buttock pain (sacroiliitis)
  • Swollen toes or fingers ('sausage digits' or dactylitis)
  • Mouth sores and skin rashes, especially on the palms or soles
  • Fatigue and low-grade fever

Experiencing these symptoms? Get expert care today.

How is Reactive Arthritis Diagnosed?

Diagnosing reactive arthritis involves connecting the onset of joint inflammation to a preceding infection. Dr. Forouzesh takes a detailed medical history, including recent infections, gastrointestinal illness, or urinary symptoms, and performs a thorough physical examination. Blood tests may include inflammatory markers (ESR and CRP), HLA-B27 genetic testing (positive in about 75% of cases), and tests to identify or rule out an active infection. Joint fluid analysis may be performed to exclude other causes such as gout or septic arthritis. Imaging with X-rays or MRI can reveal joint inflammation, enthesitis, or sacroiliitis. There is no single definitive test, so the diagnosis relies on the overall clinical picture.

Treatment Options

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs such as indomethacin or naproxen are the first-line treatment to reduce joint pain and inflammation. They are effective for most patients with mild to moderate symptoms.

Corticosteroid Injections

Joint or tendon sheath injections deliver anti-inflammatory medication directly to severely affected areas, providing targeted relief.

Disease-Modifying Drugs (DMARDs)

Sulfasalazine or methotrexate may be used for patients with persistent or chronic reactive arthritis that does not respond to NSAIDs.

Antibiotic Treatment

If an active infection is identified, appropriate antibiotic therapy is prescribed to treat the underlying infection triggering the inflammatory response.

Physical Therapy

Stretching, strengthening, and range-of-motion exercises to maintain joint function and prevent stiffness during the recovery period.

Key Statistics

1-4%

Of people develop reactive arthritis after bacterial infection

Source: American College of Rheumatology

3:1

Male-to-female ratio (more common in men)

Source: NIH/NIAMS

20-40

Most common age of onset (years)

Source: Spondylitis Association of America

Frequently Asked Questions

The most common triggering infections include bacterial infections of the gastrointestinal tract (Salmonella, Shigella, Campylobacter, Yersinia) and sexually transmitted infections of the urogenital tract (Chlamydia trachomatis). The arthritis is not caused by the bacteria being in the joints but rather by the body's immune response to the infection.
Most cases of reactive arthritis resolve within three to twelve months. However, about 15-20% of patients develop chronic symptoms lasting more than a year, and some may experience recurrent episodes. Early treatment and management of the triggering infection can help shorten the course of the disease.
Reactive arthritis itself is not contagious. However, the infections that trigger it (such as Chlamydia or Salmonella) can be spread from person to person. Not everyone who gets these infections will develop reactive arthritis — genetic factors, particularly the HLA-B27 gene, play a role in susceptibility.
HLA-B27 is a genetic marker found in about 75% of people with reactive arthritis. Having this gene increases the risk of developing the condition after a triggering infection, but many people with HLA-B27 never develop reactive arthritis. Testing for HLA-B27 can support the diagnosis but is not required to confirm it.

Ready to Get Expert Care?

Schedule your appointment with Dr. Solomon Forouzesh, MD, FACP, FACR — a board-certified rheumatologist with 50++ years of expertise in arthritis and autoimmune diseases.

Culver City Office

9808 Venice Blvd, Suite 604

Culver City, CA 90232

(310) 204-6811

Encino Office

5400 Balboa Blvd, Suite 103

Encino, CA 91316

(310) 204-6811