What are the signs and symptoms of reactive arthritis (ReA)?

Updated: Dec 24, 2020
  • Author: Carlos J Lozada, MD; Chief Editor: Herbert S Diamond, MD  more...
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The classic triad of ReA symptoms (found in only one third of patients) consists of the following:

  • Noninfectious urethritis
  • Arthritis
  • Conjunctivitis

In postenteric ReA, diarrhea and dysenteric syndrome (usually mild) is commonly followed by the clinical triad in 1-4 weeks. Some add a fourth component (mucocutaneous findings) to make up a diagnostic tetrad.

The following may be noted:

  • Acute onset of ReA, with malaise, fatigue, and fever
  • Asymmetrical, predominantly lower-extremity, oligoarthritis as the major presenting symptom, sometimes with early myalgias
  • Initial nongonococcal urethritis, with frequency, dysuria, urgency, and urethral discharge
  • In addition to conjunctivitis, ophthalmologic symptoms that include erythema, burning, tearing, photophobia, pain, and decreased vision (rare)
  • Mild recurrent abdominal complaints after a precipitating episode of diarrhea
  • In HIV-positive patients, severe psoriasiform dermatitis, commonly involving the flexures, scalp, palms, and soles

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