MEDICAL GP 7B - Bridget Sarpong

UNIVERSITY OF CAPE COAST
SCHOOL OF NURSING AND MIDWIFERY
DEPARTMENT OF ADULT HEALTH
MEDICAL NURSING III
GROUP SEVEN (7B)
REITER’S SYNDROME
OBJECTIVES
At the end of this presentation, one • Diagnostic measures

would know all about reiter’s
• Medical and surgical
syndrome;
management
• Introduction
• Nursing management
• Risk factors
• Major problems of the patient
• Causes
• Patient and the family
• Incidence education
• Pathophysiology • Complications
• Clinical manifestations • Rehabilitation
REITER’S SYNDROME
• Reiter’s syndrome is a painful form of inflammatory arthritis that develops
in reaction to an infection by bacteria or virus.
• It is an autoimmune disease and belongs to a group of inflammatory
diseases called spondyloarthropathies, which primarily impact the joints
and nearby structures.
• Reiter’s syndrome is also known as reactive arthritis or Reiter’s arthritis
• Reiter’s arthritis is an RF-seronegative, HLA B27-linked arthritis, often
precipitated by genitourinary or gastrointestinal infections
• When the arthritis is followed by characteristics of other symptoms it is
then called reiter’s arthritis
• The arthritis may be ‘’additive’’ (more joints become inflamed in
addition to the primarily affected one).
• Migratory (new joints become inflamed after the initially inflamed
site has already improved)
• Normally, Reiter's syndrome is a complex featuring a triad that
compromises ocular involvement with conjunctivitis and/or
uveitis, articular manifestation (reactive arthritis), genital urethral
involvement such as urethritis or cervicitis
• Arthritis is accompanied by sporadic pain and inflammation in the joints,
affecting the large joints in lower extremities in the following frequency
order: knees, ankles, feet joints, shoulders, wrists, hips and lumbar spine.
Sacroiliitis has also been identified widely.
• Certain genes of the human leukocyte antigen (HLA) family, particularly HLA-
B27, are strongly associated with the onset of Reiter's syndrome. However, it
should be noted that not all individuals with the HLA-B27 gene develop the
syndrome, indicating that other environmental factors are required for its
manifestation.
RISK FACTORS
Risk factors related to Reiter's syndrome include:

• A history of sexually transmitted infections.
• Patients aged between 20 and 40 years old.
• Family relatives affected by Reiter's syndrome.
• Genetic traces associated with HLA-B27 gene.
• Digestion of contaminated foods.
• Male patients.
• Frequent change of sexual partners.
CAUSES
The precise cause is not completely understood but the following can lead
to it:
• Streptococcal throat infection
• Glandular fever
• Viral flu
• Food poisoning
• Sexually acquired
INCIDENCE
• It most commonly strikes individuals aged 20-40 years of age.

• It is more common in men than in women
• It is more common in white than in black people, this is owing to
the high frequency of the HLA-B27 gene in the white population.
• Patients with HIV have an increased risk of developing reactive
arthritis as well.
PATHOPHYSIOLOGY
• It occurs in reaction to an infection by certain bacteria or virus.

• Most often, these bacteria are in the genitals ( chlamydia
trachomatis) or the bowel (Campylobacter, Salmonella, Shigella
and Yersina).
• These microorganisms can induce an abnormal immune
response, leading to an autoimmune reaction directed against
the body's own antigens.
CLINICAL MANIFESTATION
• Burning pain on urination (dysuria) or an increased frequency of

urination
• Prostatitis in men and cervicitis, salpingitis, and/or vulvovaginitis in
women
• Penile lesions called balanitis circinata (circinate balanitis) can be
found in males
• Inflammation of the eyes in the form of conjunctivitis or uveitis
• Swelling and pain in large joints such as the knee
• Enthesitis can involve the Achilles tendon resulting in heel pain
• A small percentage of men and women develop small hard
nodules called keratoderma blennorrhagica on the soles of the
feet
• Because common systems involved include the eye, the urinary
system, and the hands and feet, one clinical mnemonic for
Reiter’s syndrome is ‘’Can’t see, can’t pee can’t climb a tree’’
DIAGNOSIS
• Diagnosing Reiter's syndrome requires a thorough assessment of the
patient's medical history, physical examination, and appropriate diagnostic
measures. Nurses play a crucial role in assisting with these procedures and
ensuring patient comfort and understanding.
• There are no specific examinations for Reiter’s syndrome making conclusions
difficult.
• A diagnose can be drawn using risk factors, a history of enteric or sexually
transmitted infections, as well as symptoms and physical examination.
• A diagnosis is drawn when a patient presents a peripheral joint dysfunction
over a period of a month, accompanied by urethritis, cervicitis or one of the
manifestations beyond those in the joints.
• Blood tests may reveal an elevated erythrocyte sedimentation rate (ESR)
and C-reactive protein (CRP), indicating ongoing inflammation in the body.
• Rheumatoid factor (RF) and antinuclear antibodies (ANA) are usually
negative in Reiter's syndrome.
• Chlamydia testing.
• Arthrocentesis - where a sample of synovial fluid is obtained from the joint in
order to examine it.
• X-rays, showing spondylitis, sacroiliitis, arthritis of damage to the joints.
• Nuclear magnetic resonance (NMR) and computerized axial tomography
(CAT) scan to register bone and internal organ imaging.
• Leukocyte count, looking for signs of infection
• In a chronic phase, hemograms can show anemia.
• Genetic factor studies associated with the HLA-B27 entity.
• MRI scans provide detailed images of soft tissues, allowing for the
detection of early inflammatory changes and enthesitis.
TREATMENT
The main goal of treatment is to identify and eradicate the underlying infectious
source with the appropriate antibiotics, otherwise, treatment is symptomatic for
each problem. Generally, recommended treatments include;
• Resting whilst the joint inflammation persists.
• The use of crutches when the knee is swollen.
• Physiotherapy, with moderate exercises to ameliorate flexibility and to
strengthen muscles in order to improve joint support.
• Immunosuppressants may be needed for patients with severe reactive
symptoms that do not respond to any other treatment.
• Medical treatment is prescribed to couples suffering from Chlamydia
inflection, with the administration of 100 mg doxycycline twice a day for at
least 3 months.
• Tetracycline has been known to be successful when the infection is caused
by Chlamydia Trachomatis.
• Anti-inflammatories and painkillers such as aspirin, ibuprofen
• Some researches recommend indometacin and tolmecin to control the
disorder within a few weeks or months.
• Corticosteroid treatment is not recommended, and only when swelling
persists these should be administered via injection.
• Local glucocorticoid injections are recommended for entesitis or
resistant oligoarthritis.
• No surgical therapy for reactive arthritis is recommended,however
surgical intervention may be warranted for certain ocular
manifestations of the disease.
NURSING MANAGEMENT
• Nursing management for patients with Reiter's syndrome focuses on
providing holistic care, promoting symptom relief, and improving the
patient's overall well-being. The nursing interventions are tailored to address
the specific needs of each patient and may include the following:
• Pain management and promotion of comfort.
• Mobility assistance.
• Education of patients about proper hygiene practices and skin care to
prevent complications.
• Administration of prescribed medication.
• Psychosocial support.
PATIENT AND FAMILY EDUCATION
• Educate patients on self-management strategies for pain control.

• Educate patients on joint protection techniques and relaxation
exercises.
• Educate patients about proper hygiene practices and skin care to
prevent complications.
• Medication education, including explaining the purpose, dosage, and
potential side effects of prescribed medications. Emphasize the
importance of adherence to the treatment plan and provide
information on self-administration techniques when applicable.
COMPLICATIONS
Generally, complications are rare. Nonetheless, they have been found in

several organs
• Pulmonary: Pneumonia, pleurisy.
• Nervous system: Neuropathy, malfunction.
• Cardiac: Aortic malfunction, pericarditis, arrhythmia and aortic necrosis,
this being secondary to the treatment.
• Ocular: Cataract.
• Joints: Persistent arthritis, chronic arthritis or sacroiliitis, ankylosing
spondylitis.
REHABILITATION
Rehabilitation programs may be necessary for patients with

severe joint involvement in Reiter's syndrome. These
programs focus on restoring joint function, promoting
physical activity, and optimizing overall well-being.
THANK YOU
GROUP MEMBERS
ANNABELLE CROFIELD- COKER SN/NUS/20/0104
DANIELLA GYEKYEBEA ADJEI SN/NUS/20/0100
BRIDGET AFUA AMOANIMAAH SARPONG SN/NUS/20/0101
MABEL AMOAKOSAH KUOFI SN/NUS/20/0105
FRANCIS SAM SN/NUS/20/0096
BENJAMIN FRIMPONG SN/NUS/20/0093

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UNIVERSITY OF CAPE COAST

SCHOOL OF NURSING AND MIDWIFERY

DEPARTMENT OF ADULT HEALTH

MEDICAL NURSING III

GROUP SEVEN (7B)

At the end of this presentation, one • Diagnostic measures

Risk factors related to Reiter's syndrome include:

• It most commonly strikes individuals aged 20-40 years of age.

• It occurs in reaction to an infection by certain bacteria or virus.

• Burning pain on urination (dysuria) or an increased frequency of

• Educate patients on self-management strategies for pain control.

Generally, complications are rare. Nonetheless, they have been found in

Rehabilitation programs may be necessary for patients with

ANNABELLE CROFIELD- COKER SN/NUS/20/0104

DANIELLA GYEKYEBEA ADJEI SN/NUS/20/0100

BRIDGET AFUA AMOANIMAAH SARPONG SN/NUS/20/0101

MABEL AMOAKOSAH KUOFI SN/NUS/20/0105

FRANCIS SAM SN/NUS/20/0096

BENJAMIN FRIMPONG SN/NUS/20/0093

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