Diagnosis
During the physical exam, your doctor is likely to check your joints for swelling, warmth and tenderness, and test range of motion in your spine and affected joints. Your doctor might also check your eyes for inflammation and your skin for rashes.
Blood tests
Your doctor might recommend that a sample of your blood be tested for:
- Evidence of past or current infection
- Signs of inflammation
- Antibodies associated with other types of arthritis
- A genetic marker linked to reactive arthritis
Joint fluid tests
Your doctor might use a needle to withdraw a sample of fluid from within an affected joint. This fluid will be tested for:
- White blood cell count. An increased number of white blood cells might indicate inflammation or an infection.
- Infections. Bacteria in your joint fluid might indicate septic arthritis, which can result in severe joint damage.
- Crystals. Uric acid crystals in your joint fluid might indicate gout. This very painful type of arthritis often affects the big toe.
Imaging tests
X-rays of your low back, pelvis and joints can indicate whether you have any of the characteristic signs of reactive arthritis. X-rays can also rule out other types of arthritis.
Treatment
The goal of treatment is to manage your symptoms and treat an infection that could still be present.
Medications
If your reactive arthritis was triggered by a bacterial infection, your doctor might prescribe an antibiotic if there is evidence of persistent infection. Which antibiotic you take depends on the bacteria that are present.
Signs and symptoms of reactive arthritis may be eased with:
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Prescription nonsteroidal anti-inflammatory drugs (NSAIDs), such as indomethacin (Indocin), can relieve the inflammation and pain of reactive arthritis.
- Steroids. A steroid injection into affected joints can reduce inflammation and allow you to return to your usual activity level. Steroid eye drops may be used for eye symptoms, and steroid creams might be used for skin rashes.
- Rheumatoid arthritis drugs. Limited evidence suggests that medications such as sulfasalazine (Azulfidine), methotrexate (Trexall) or etanercept (Enbrel) can relieve pain and stiffness for some people with reactive arthritis.
Physical therapy
A physical therapist can provide you with targeted exercises for your joints and muscles. Strengthening exercises increase the joint's support by developing the muscles around the affected joints. Range-of-motion exercises can increase your joints' flexibility and reduce stiffness.
Preparing for your appointment
You'll likely start by seeing your primary care provider, who might refer you to a doctor who specializes in arthritis (rheumatologist) for further evaluation.
What you can do
When you make the appointment, ask if there's anything you need to do in advance, such as fasting before having a specific test. Make a list of:
- Your symptoms, including any that seem unrelated to the reason for your appointment
- Key personal information, including your medical history and your family's medical history
- All medications, vitamins or other supplements you take, including doses
- Questions to ask the doctor
Take a family member or friend along, if possible, to help you remember the information you're given. For reactive arthritis, basic questions to ask your doctor include:
- What is likely causing my symptoms or condition?
- What are other possible causes?
- What tests do I need?
- What treatment approach do you recommend?
- How soon do you expect my symptoms to improve with treatment?
- Is there anything I can do now to help relieve my joint pain?
- Am I at risk of long-term complications from this condition?
- I have these other health conditions. How can I best manage them together?
Don't hesitate to ask other questions.
What to expect from your doctor
Your doctor is likely to ask you a number of questions, such as:
- When did your symptoms begin?
- Have they been continuous or occasional?
- How severe are your symptoms?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
- Have you had a recent infection?
