reactive arthritis or ritir

[stressed 17]

hi dr.
     i had a unprotected sexual intercourse on 11 march 6 months ago and have had all these problems
1  had a lot of starin on my heels and by ankle back tendons
2  had on and off pain in the lower back
3  had problem in my eyes as well like conjuctivitis kinda of feeling along with a headache that is also on a off.
4 i feel fatique all the time my muscles feel; so tired.
5 also have some ulcers in the mouth the there is always some white caoting on the tongue.Main problem is my heels and ankles every morning i wake up its d same no imrovment wht so ever.

the only problem i was diagonsed for after the sex was uti which showed i had the bacteria e coli, for which also i took a long course of antibiotics almost 1 month after that i got my urine checked nothing showed up in the test but i still had my above given problems.

now i just wanna knw is this reactive arthritis is there anyways it can be diagonsed which kind of dr. shld i see for this diesease and this curable? or less chronic as compared to regular arthritis. thanks dr i would appriciate your valuble response because i not able to carry on my normal activities.and if curable how long more i have to suffer with this its six months since i have been suffering.

[yarrow]

It does sound as though you might consider Reiter's or "reactive arthritis" (the more P-C term these days).  About three years ago, I  (a long-married, faithful woman) got severe food poisoning at a local restaurant, and about three weeks later, began developing the weirdest joint problems, mostly the S-I and one "sausage finger."  It went on and on, slowly involving a swollen knee here, painful ribs there, etc., untll, a year later, I was having trouble just walking around the block.  I wasn't dreadfully ill, or dreadfully disabled, but my life was definitely changed for the worse.

A local rheumatologist finally took me on, diagnosed me, tested me (I was negative for HLA-B27), and put me on a trial of 100mg minocycline once per day.  Within a week, the symptoms were essentially gone.  I stayed on this regime for a year, and the symptoms did not return, so the doc tapered me off minocycline.  That was four years ago.  Now, maybe once a year, a joint will flare up, and when it does, I restart the minocycline for a few months, and so far, the condition has subsided in a most reliable way.

This is a non-standard use for an old and pretty safe drug that has anti-inflammatory qualities (in the news lately as a treatment for stroke).  You might want to ask your rheumatologist about it.  There is a related website/bulletin board called "The Road Back," where you can find troubled people looking for weird answers to weird questions,  but where you can also find some helpful and not too-far-out info.

[Kevin Pho, MD]

Evaluation of various rheumatologic diseases can be certainly considered with the symptoms you present.  I would start with a blood count, sedimentation rate, ANA level, and rheumatoid factor.

Reiter's syndrome typically presents with the constellation of arthritis, urethritis and conjunctivitis.  If this is considered HLA-B27 testing should be done.

These options should be discussed with your personal physician, or in conjunction with a rheumatologist.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_