title: Poststreptococcal reactive arthritis and the association with tendonitis, tenosynovitis, and enthesitis.
abstract: OBJECTIVE
  To study the clinical presentation of poststreptococcal reactive arthritis (PSRA) and its periarticular manifestation.
  
  
  METHODS
  This is a retrospective study. The files of all patients diagnosed with PSRA between January 2004 and November 2007 were reviewed with a predetermined checklist. Patients were included if they met our study criteria for diagnosis of PSRA.
  
  
  RESULTS
  A total of 33 files were reviewed; 26 of these patients (14 female, 12 male, Arab and Asian, aged 11-41 years) met our agreed protocol for the diagnosis of PSRA. The ethnic backgrounds of the patients were as follows: 18 patients were from Arab origins and 8 patients were Asians. Twenty-one patients (80%) had asymmetric complaints, whereas 5 patients (20%) had symmetrical complaints. Two patients (7.6%) had monoarthritis, 8 patients (30.76%) had oligoarthritis, and 11 patients (42.3%) had polyarthritis. Five patients (19.23%) had only polytendonitis, tenosynovitis, and/or enthesitis. Nine patients (34.61%) had tendonitis, tenosynovitis, or enthesitis alone or with arthritis/arthralgia. The average elevation of antistreptolysin antibodies titer was 624.8 and the average sedimentation rate 44 mm/H. The response to nonsteroidal antiinflammatory drugs was generally good (84.6%), being poor in only 4 patients (15.38%) who required treatment with corticosteroids. Prophylactic penicillin was given to 15 patients (57%). No patient had carditis on presentation or follow-up.
  
  
  CONCLUSIONS
  It is concluded that polytendonitis, tenosynovitis, and enthesitis are common presentations in PSRA and could be the only manifestation of poststreptococcal infection.
authors.affiliation: Department of Medicine, Hamad Medical Corporation, Doha, Qatar. sarakbi@yahoo.com
authors.forename: Housam Aldeen
authors.initials: HA
authors.lastname: Sarakbi
authors.forename: Mohammed
authors.initials: M
authors.lastname: Hammoudeh
authors.forename: Izzat
authors.initials: I
authors.lastname: Kanjar
authors.forename: Samar
authors.initials: S
authors.lastname: Al-Emadi
authors.forename: Salah
authors.initials: S
authors.lastname: Mahdy
authors.forename: Abdulrahim
authors.initials: A
authors.lastname: Siam
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D016918:Arthritis, Reactive / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D001799:Blood Sedimentation; D002648:Child; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012698:Serologic Tests; D013290:Streptococcal Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D013297:Streptococcus pyogenes; D013717:Tenosynovitis / Q000188:drug therapy / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal