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39 Cards in this Set

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Reiter syndrome is considered a form of what type of arthritis?
Reactive arthritis
What’s the classic triad associated with Reiter syndrome?
Urethritis, Conjunctivitis, & Arthritis
Triad only seen in ~ 1/3 of cases
T or F: Reiter Syndrome is thought to have a venereal or enteric connection.
True
What region is usually affected by Reiter syndrome?
Lower extremity
T or F: Reiter syndrome is a sterile (aseptic) inflammatory process that occurs distant to the primary focus of infection.
True
What gender most commonly is affected by Reiter’s syndrome? What’s the most common age?
Males, 18-40 y.o
When does Reiter syndrome m/c occur?
w/in days to weeks of GU infection or dysentery
What organisms cause Reiter syndrome?
Chlamydia trichomatosis
Shigella flexneri
Yersinia Enterocolitica
Salmonella
What’s usually the initial manifestation of Reiter syndrome?
Urethritis
What symptom is associated with urethritis typical of Reiter syndrome?
Circinate balanitis (20-80% of cases) – small painless ulcers on the glans penis & urethral meatus
T or F: Conjunctivitis assoc. w/ Reiter syndrome is seen early, transient, & bilateral.
True
T or F. Arthritis assoc w/ Reiter syndrome is asymmetric, prefers the lower extremity & most commonly a polyarthritis in young men.
True
Name the skin lesion caused by Reiter syndrome found on the soles of the feet & palms of the hands.
Keratoderma blennorrhagica
Seen in up to 30%
Distinctive lesion almost identical to pustular psoriasis
T or F. Mucocutaneous lesions assoc w/ Reiter syndrome occur in the oral mucosa, tongue & hard palate.
True. Similar to circinata balanitis
What is Periosteal new bone formation in the SPINE assoc w/ Reiter syndrome called?
Parasyndesmophytes
What is Periosteal new bone formation in the APPENDICULAR skeleton assoc w/ Reiter syndrome called?
Periostitis
Periosteal new bone formation in the calcaneus assoc w/ Reiter syndrome is called…?
Lover’s heel
T or F: Reiter syndrome causes synovitis producing erosions in the involved jt & at the enthuses.
True
What laboratory results are assoc w/ Reiter syndrome?
Slight anemia (normocytic, normochromic)
Elevated ESR (acute phase)
+ HLA-B27 (75%)
- RA factor
Leukocytosis (incr. WBCs)
What's the distribution of Reiter syndrome?
Bilateral ASYMMETRICAL distribution
What parts of the lower extremity does Reiter syndrome most effect?
MTP and IP jts of feet
Calcaneus
Ankle
Knee
Hip is SPARED!
Describe the articular/periarticular soft-tissue swelling seen in Reiter.
Not specific, may have sausage-like swelling
T or F. Regional or periarticular osteoporosis may occur with Reiter syndrome.
True (though uncommon)
Describe joint space narrowing seen with Reiter syndrome.
Uniform, m/c seen in small articulations
Where are bone erosions noted with Reiter Syndrome?
Both appendicular & axial skeleton
Marginal then progress to central
Superficial resorption beneath inflamed bursa or tendons
Where are Reiter Syndrome bone erosions most common?
Small joints of the feet
Bone proliferation/periostitis caused by Reiter syndrome is a prominent feature found most commonly in what locations?
Metatarsals
Phalangeal shafts
Malleolar region
Knee
T or F. Bone proliferation/periostitis caused by Reiter syndrome can be linear of fluffy.
True
T or F. Enthesopathic changes are commonly seen in Reiter syndrome.
True. (Enthesopathic = at site of insertion of muscle, tendons and ligaments into bones or joint capsules.)
Reiter syndrome causes tendinous calcificaiton/ossification around which joint?
Knee joint (May look like Pellegrini-Stieda)
Launois' deformity assoc with Reiter syndrome occurs in what region?
Foot
How does Reiter syndrome affect the foot?
Asymmetrical involvement of MTP & IP joints

Sesamoid bones can undergo erosions & proliferation

Launois' deformity
How does Reiter syndrome affect the ankle/tarsal?
Calcaneal alterations (characteristic)

Occur on both posterior & plantar aspects

Retrocalcaneal bursitis

Thickened Achilles' tendon
T or F. Reiter syndrome causes ossification of the medial collateral ligament of the knee.
True. Knee effusions are also seen
How does Reiter syndrome / Reactive arthritis affect the SI joint?
Sacroilitis - Bilateral, asymmetric erosions, hazy joints, & variable sclerosis

Common finding (up to 50%)
Bone scans demonstrate up to 70% involvement
What part of the spine is most commonly affected by Reiter syndrome / Reactive arthritis?
Lower Thoracic & Upper Lumbar spine
What's the appearance of Reiter syndrome / Reactive arthritis in the spine?
Paravertabral ossification similar to PA

Asymmetrical
How does Reiter syndrome / Reactive arthritis affect the hand/wrist?
PIP jt most frequently
Distinctly unusual
T or F. Reiter Syndrome / Reactive arthritis can cause Osseous Erosions & Bony Proliferation at the symphysis pubis & manubriosternal jt
TRUE

:)