Reactive arthritis or chronic infectious arthritis?

Abstract

Microbes reach the synovial cavity either directly during bacteraemia or by transport within lymphoid cells or monocytes. This may stimulate the immune system excessively, triggering arthritis. Some forms of ReA correspond to slow infectious arthritis due to the persistence of microbes and some to an infection triggered arthritis linked to an extra-articular site of infection.

Figure 1

The spectrum of arthritis induced by a bacterial infection. The host-bacterium interactions and, in particular, the bacterial virulence factors lead to different forms of arthritis. In some cases there may be no more than a simple "bystander" bacterial presence in the synovium.

Figure 2

Natural history of arthritogenic infections in reactive arthritis. See also Box 1.