A 22 year old man presented at the accident and emergency department with a two week history of a rash on his penis and the soles of his feet. He also complained of sore eyes and of pains in his ankles and left wrist.
There is no specific test to confirm the presence or absence of a reactive arthritis. Diagnosis is made on clinical grounds. It is important to consider and exclude the differential diagnosis of acute gonococcal arthritis. Taking urethral swabs for gonococcal cultures can do this, and, unlike a reactive arthritis, gonococcal arthritis will respond quickly to penicillin treatment
Reiter's syndrome lasts between days and months. Treatment is based on relieving the symptoms, and the maintenance of function of the joints. The arthritis usually responds to non-steroidal anti-inflammatory drugs such as ibuprofen, but occasionally persistent joint disease may require a second line drug such as methotrexate. Physiotherapy is