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Reactive arthritis — SCE Rheumatology MCQ

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ModerateSpondyloarthropathiesReactive arthritisSCE Rheumatology

A 25-year-old man develops asymmetric ankle and knee arthritis four weeks after dysuria. He has conjunctivitis, circinate balanitis and Achilles enthesitis. Chlamydia nucleic acid amplification test is positive. What is the most appropriate management?

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Correct answer: E — Treat chlamydia and manage arthritis with NSAIDs and local steroid where appropriate

Reactive arthritis after chlamydial infection requires treatment of the infection and partner notification, with arthritis managed using NSAIDs and injections if needed. Prolonged antibiotics solely for arthritis are not routinely recommended. Persistent severe disease may need DMARDs, but not as the initial step in this presentation.

Reference: NICE NG65; BASHH chlamydia guidance