MorbusReiter
diagnosis-reactive-arthritis

Diagnosis

There are few clinical symptoms, but the clinical picture is dominated by polyarthritis. There is pain, swelling, redness, and heat in the joints affected. MRI is effective in diagnosis.

The urethra, cervix and the throat may be swabbed in an attempt to culture the causative organisms. Cultures may be carried out on urine and stool samples. Arthrocentesis can be done in order to study the synovial fluid from an affected joint for further cell count, and for culture.

Also, a blood test for the genetic marker HLA-B27 may be given to determine if the patient has the gene. About 75 percent of all the patients with Reiter's arthritis have the gene. C-Reactive Protein (CRP), and Erythrocyte Sedimentation Rate (ESR) are non-specific tests that can be done to corroborate the diagnosis of the syndrome.

Diagnostic Criteria

Although there are no definitive criteria to diagnose the existence of Reiter's arthritis, the American College of Rheumatology has published sensitivity and specificity guidelines.

Percent Sensitivity and Specificity of Various Criteria for Typical Reiter's Syndrome
Method of diagnosis Sensitivity Specificity
1. Episode of arthritis of more than 1 month with urethritis and/or cervicitis 84.3% 98.2%
2. Episode of arthritis of more than 1 month and either urethritis or cervicitis, or bilateral conjunctivitis 85.5% 96.4%
3. Episode of arthritis, conjunctivitis, and urethritis 50.6% 98.8%
4. Episode of arthritis of more than 1 month, conjunctivitis, and urethritis 48.2% 98.8%
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