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Reactive Arthritis — SCE Rheumatology MCQ

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EasySpondyloarthropathyReactive ArthritisSCE Rheumatology

A 30-year-old man with reactive arthritis develops circinate balanitis and keratoderma blennorrhagicum on the soles. He has an asymmetric oligoarthritis affecting the left knee and right ankle. Which triad is historically associated with reactive arthritis?

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Correct answer: D — Arthritis, urethritis and conjunctivitis

The historically described triad is **arthritis, urethritis and conjunctivitis**. Reactive arthritis commonly presents as an acute asymmetric oligoarthritis predominantly affecting lower-limb joints after a gastrointestinal or genitourinary infection. Circinate balanitis and keratoderma blennorrhagicum are characteristic associated mucocutaneous manifestations. The complete historical triad occurs in only a subset of patients and is not required for diagnosis; HLA-B27 may support the clinical context or indicate a greater risk of persistent disease but is not diagnostic. Arthritis with psoriasis and nail disease suggests psoriatic arthritis. Recurrent oral and genital ulceration with uveitis suggests Behçet syndrome, while xerostomia and keratoconjunctivitis sicca suggest Sjögren syndrome.

Reference: Carter JD, Hudson AP. Reactive arthritis: clinical aspects and medical management. Rheumatic Disease Clinics of North America. 2009;35(1):21–44. https://pubmed.ncbi.nlm.nih.gov/19480995/