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Reactive poststreptococcal arthritis
From WikEM
(Redirected from Reactive Arthritis (Poststreptococcal))
Contents
Background
- Arthritis of one or more joints after Group A strep pharyngitis
- May represent mild form of rheumatic fever or separate entity
- Not associated with other Major Jones criteria; milder illness than rheumatic fever
Clinical Features
- Begins approximately 10d after strep infection (compared to 21d for rheumatic fever)
- Arthritis
- Generally more severe than that in RF
- Non-migratory, mono or oligoarthritis
- ASA-resistant
- Erythema nodosum and erythema multiforme are frequently seen
Differential Diagnosis
Monoarticular arthritis
- Acute osteoarthritis
- Avascular necrosis
- Crystal-induced (Gout, Pseudogout)
- Gonococcal septic arthritis
- Nongonococcal septic arthritis
- Lyme disease
- Malignancy
- Reactive poststreptococcal arthritis
- Trauma-induced arthritis
Polyarthritis
- Fibromyalgia
- Juvenile idiopathic arthritis
- Lyme disease
- Osteoarthritis
- Psoriatic arthritis
- Reactive poststreptococcal arthritis
- Rheumatoid arthritis
- Rheumatic fever
- Serum sickness
- Systemic lupus erythematosus
- Serum sickness–like reactions
- Viral arthritis
Evaluation
Management
- Penicillin if GAS is recovered from the throat
- NSAIDs
Disposition
- Discharge
