Reactive arthritis: Defined etiologies, emerging pathophysiology, and unresolved treatment

Reactive arthritis (ReA) is an inflammatory arthritis that arises after certain types of gastrointestinal or genitourinary infections. Approximately half of the patients with ReA experience spontaneous resolution of their symptoms within 6 months and half develop chronic ReA. The triggering microbes of ReA are gram-negative bacteria with a lipopolysaccharide component of their cell walls. All of these bacteria, or their bacterial products, have been demonstrated by polymerase chain reaction technology in the synovial tissue or fluid of patients with ReA; however, these findings have been questioned. Traditional therapies include nonsteroidal anti-inflammatory drugs, corticosteroids, and disease-modifying antirheumatic drugs; the role of antibiotics is not yet fully defined.