Arthritis, reactive

M02.30-39

DESCRIPTION

A spondylarthritis often preceded by enteric or urogenital infections 1–4 weeks before the arthritis and occurring predominantly in individuals with HLA-B27 antigen.

It is a clinical diagnosis with no laboratory test or radiographic findings.

It occurs more commonly in HIV infection.

It is usually self-limiting.

MEDICINE TREATMENT

  • NSAID, e.g.:
  • Ibuprofen, oral, 400 mg 8 hourly with meals.

LoEI [27]

In high-risk patients: i.e. patients > 65 years of age, or with a history of peptic ulcer disease, or on concomitant warfarin, aspirin or corticosteroids:

LoEII [28]

ADD

  • PPI, e.g.:
  • Lansoprazole, oral, 30 mg daily.

If urethritis is present, treatment may prevent further episodes of arthritis:

  • Ceftriaxone, IM, 250 mg as a single dose.
    • For ceftriaxone IM injection: Dissolve ceftriaxone 250 mg in 0.9 mL lidocaine 1% without epinephrine (adrenaline).

AND

  • Azithromycin, oral, 1 g, as a single dose.

LoEIII [29]