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Poststreptococcal Reactive Arthritis
Aka: Poststreptococcal Reactive Arthritis, Post-streptococcal Reactive arthritis
- See Also
- Group A Streptococcus
- Group A Streptococcal Pharyngitis
- Rheumatic Fever
- Viral Arthritis
- Reactive Arthritis
- Epidemiology
- Peak ages affected
- Ages 8 to 14 years old
- Ages 21 to 37 years old
- Pathophysiology
- Autoimmune response to Group A Streptococcus
- Onset 7-10 days after Group A Streptococcal Pharyngitis
- May occur with or without Rheumatic Fever
- Part of Jones Criteria for Rheumatic Fever diagnosis
- Symptoms
- Persistent or recurrent non-Migratory Arthritis
- Distribution
- Most commonly affects hip, knee, ankle and wrist
- Labs
- Complete Blood Count (CBC)
- Acute phase reactants (lower levels than with Rheumatic Fever)
- Erythrocyte Sedimentation Rate (ESR)
- C-Reactive Protein (C-RP)
- Streptococcus Testing
- GAS Rapid Antigen test with reflex to Throat Culture if negative
- ASO Titer
- Differential Diagnosis
- Septic Arthritis
- Always exclude in Monoarthritis
- Rheumatic Fever
- Arthritis with other Rheumatic Fever criteria (see Jones Criteria)
- Viral Arthritis
- Reactive Arthritis
- Management
- Antiinflammatory medications
- NSAIDs and Aspirin are less effective than in the Arthritis of Rheumatic Fever
- Monitor for carditis (and Rheumatic Fever)
- Monitoring for one year
- Benzathine Penicillin G IM monthly for one year
- References
- Maness (2018) Am Fam Physician 97(8): 517-22 [PubMed]