Reiter Syndrome (Reactive Arthritis)

Front 1

Reiter syndrome is considered a form of what type of arthritis?

Back 1

Reactive arthritis

Front 2

What’s the classic triad associated with Reiter syndrome?

Back 2

Urethritis, Conjunctivitis, & Arthritis
Triad only seen in ~ 1/3 of cases

Front 3

T or F: Reiter Syndrome is thought to have a venereal or enteric connection.

Back 3

True

Front 4

What region is usually affected by Reiter syndrome?

Back 4

Lower extremity

Front 5

T or F: Reiter syndrome is a sterile (aseptic) inflammatory process that occurs distant to the primary focus of infection.

Back 5

True

Front 6

What gender most commonly is affected by Reiter’s syndrome? What’s the most common age?

Back 6

Males, 18-40 y.o

Front 7

When does Reiter syndrome m/c occur?

Back 7

w/in days to weeks of GU infection or dysentery

Front 8

What organisms cause Reiter syndrome?

Back 8

Chlamydia trichomatosis
Shigella flexneri
Yersinia Enterocolitica
Salmonella

Front 9

What’s usually the initial manifestation of Reiter syndrome?

Back 9

Urethritis

Front 10

What symptom is associated with urethritis typical of Reiter syndrome?

Back 10

Circinate balanitis (20-80% of cases) – small painless ulcers on the glans penis & urethral meatus

Front 11

T or F: Conjunctivitis assoc. w/ Reiter syndrome is seen early, transient, & bilateral.

Back 11

True

Front 12

T or F. Arthritis assoc w/ Reiter syndrome is asymmetric, prefers the lower extremity & most commonly a polyarthritis in young men.

Back 12

True

Front 13

Name the skin lesion caused by Reiter syndrome found on the soles of the feet & palms of the hands.

Back 13

Keratoderma blennorrhagica
Seen in up to 30%
Distinctive lesion almost identical to pustular psoriasis

Front 14

T or F. Mucocutaneous lesions assoc w/ Reiter syndrome occur in the oral mucosa, tongue & hard palate.

Back 14

True. Similar to circinata balanitis

Front 15

What is Periosteal new bone formation in the SPINE assoc w/ Reiter syndrome called?

Back 15

Parasyndesmophytes

Front 16

What is Periosteal new bone formation in the APPENDICULAR skeleton assoc w/ Reiter syndrome called?

Back 16

Periostitis

Front 17

Periosteal new bone formation in the calcaneus assoc w/ Reiter syndrome is called…?

Back 17

Lover’s heel

Front 18

T or F: Reiter syndrome causes synovitis producing erosions in the involved jt & at the enthuses.

Back 18

True

Front 19

What laboratory results are assoc w/ Reiter syndrome?

Back 19

Slight anemia (normocytic, normochromic)
Elevated ESR (acute phase)
+ HLA-B27 (75%)
- RA factor
Leukocytosis (incr. WBCs)

Front 20

What's the distribution of Reiter syndrome?

Back 20

Bilateral ASYMMETRICAL distribution

Front 21

What parts of the lower extremity does Reiter syndrome most effect?

Back 21

MTP and IP jts of feet
Calcaneus
Ankle
Knee
Hip is SPARED!

Front 22

Describe the articular/periarticular soft-tissue swelling seen in Reiter.

Back 22

Not specific, may have sausage-like swelling

Front 23

T or F. Regional or periarticular osteoporosis may occur with Reiter syndrome.

Back 23

True (though uncommon)

Front 24

Describe joint space narrowing seen with Reiter syndrome.

Back 24

Uniform, m/c seen in small articulations

Front 25

Where are bone erosions noted with Reiter Syndrome?

Back 25

Both appendicular & axial skeleton
Marginal then progress to central
Superficial resorption beneath inflamed bursa or tendons

Front 26

Where are Reiter Syndrome bone erosions most common?

Back 26

Small joints of the feet

Front 27

Bone proliferation/periostitis caused by Reiter syndrome is a prominent feature found most commonly in what locations?

Back 27

Metatarsals
Phalangeal shafts
Malleolar region
Knee

Front 28

T or F. Bone proliferation/periostitis caused by Reiter syndrome can be linear of fluffy.

Back 28

True

Front 29

T or F. Enthesopathic changes are commonly seen in Reiter syndrome.

Back 29

True. (Enthesopathic = at site of insertion of muscle, tendons and ligaments into bones or joint capsules.)

Front 30

Reiter syndrome causes tendinous calcificaiton/ossification around which joint?

Back 30

Knee joint (May look like Pellegrini-Stieda)

Front 31

Launois' deformity assoc with Reiter syndrome occurs in what region?

Back 31

Foot

Front 32

How does Reiter syndrome affect the foot?

Back 32

Asymmetrical involvement of MTP & IP joints

Sesamoid bones can undergo erosions & proliferation

Launois' deformity

Front 33

How does Reiter syndrome affect the ankle/tarsal?

Back 33

Calcaneal alterations (characteristic)

Occur on both posterior & plantar aspects

Retrocalcaneal bursitis

Thickened Achilles' tendon

Front 34

T or F. Reiter syndrome causes ossification of the medial collateral ligament of the knee.

Back 34

True. Knee effusions are also seen

Front 35

How does Reiter syndrome / Reactive arthritis affect the SI joint?

Back 35

Sacroilitis - Bilateral, asymmetric erosions, hazy joints, & variable sclerosis

Common finding (up to 50%)
Bone scans demonstrate up to 70% involvement

Front 36

What part of the spine is most commonly affected by Reiter syndrome / Reactive arthritis?

Back 36

Lower Thoracic & Upper Lumbar spine

Front 37

What's the appearance of Reiter syndrome / Reactive arthritis in the spine?

Back 37

Paravertabral ossification similar to PA

Asymmetrical

Front 38

How does Reiter syndrome / Reactive arthritis affect the hand/wrist?

Back 38

PIP jt most frequently
Distinctly unusual

Front 39

T or F. Reiter Syndrome / Reactive arthritis can cause Osseous Erosions & Bony Proliferation at the symphysis pubis & manubriosternal jt

Back 39

TRUE

:)