title: Clinical presentations of chlamydial and non-chlamydial reactive arthritis.
abstract: The aim of this study was to investigate the triggering micro-organisms and the clinical as well as laboratory differences between Chlamydial and non-chlamydial reactive arthritis (ReA) in a prospective study on 98 patients with acute/subacute arthritis. An inciting organism was found in 42 patients. Eighteen of these were chlamydial. Fifty-seven percent of all ReA patients were carriers for HLA-B27, which increased to 67% in the chlamydial group. Chlamydial ReA patients had more urethritis (P<0.05) with a longer period between arthritis and inciting infection, significantly lower CRP levels, and involved joint counts (P<0.05). Additionally, sacroiliitis was more frequent besides extra-articular manifestations in chlamydial ReA group. This study shows that chlamydial ReA differs in some points from non-chlamydial ReA, which in turn may affect the evaluation of an arthritic patient. ReA due to chlamydia more frequently encompasses a monoarticular or oligoarticular clinical picture with predominant distal extremity involvement. Non-chlamydial ReA presents higher joint counts and may involve upper extremity joints.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Gulhane Military Medical Academy, 06018, Etlik-Ankara, Turkey. aozgul@gata.edu.tr
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ozgül
authors.forename: Ismail
authors.initials: I
authors.lastname: Dede
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Taskaynatan
authors.forename: Hakan
authors.initials: H
authors.lastname: Aydogan
authors.forename: Tunç Alp
authors.initials: TA
authors.lastname: Kalyon
mesh_terms: D000293:Adolescent; D000328:Adult; D016918:Arthritis, Reactive / Q000175:diagnosis / Q000276:immunology / Q000382:microbiology* / Q000473:pathology / Q000503:physiopathology; D002097:C-Reactive Protein / Q000032:analysis; D002690:Chlamydia Infections / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D015796:HLA-B27 Antigen / Q000032:analysis / Q000276:immunology; D006801:Humans; D007596:Joints / Q000473:pathology / Q000503:physiopathology; D008297:Male; D000091402:Prohibitins; D011446:Prospective Studies
chemical_list: D015796:HLA-B27 Antigen; C000717331:PHB2 protein, human; D000091402:Prohibitins; D002097:C-Reactive Protein