Poststreptococcal reactive arthritis and the association with tendonitis, tenosynovitis, and enthesitis.
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.
Sarakbi
Housam Aldeen
HA
Department of Medicine, Hamad Medical Corporation, Doha, Qatar. sarakbi@yahoo.com
Hammoudeh
Mohammed
M
Kanjar
Izzat
I
Al-Emadi
Samar
S
Mahdy
Salah
S
Siam
Abdulrahim
A
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
D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal