1. Reiters arthritis

2. It is a clinical syndrome triggered by a specific etiological agent in a susceptible host following enteric or urogenital infections targeting predominantly HLA-B27 +ve person

3. It is a triad of Arthritis ,urethritis,and uveitis plus mucocutaneous lesions

4. History Described by Hans Reiter in 1916

6. Association of HLA B 27 and Spondyloarthropathies(in whites) -8% General healthy population -50% Acute iritis -70% UnspA -40-50% Psoriatic spA -35-75% Enteropathic spA -70% Juvenile spondyloarthropathy 40-80% ReA -90% Ankylosing spondylitis HLA B 27 prevalence Disease

10. Isolated reports of acute arthritis preceded by even viral and parasitic infection

12. In summery advance in molecular research have revealed that an imbalance in inflammation cytokines is central in there pathogenesis

14. Symptoms of triggering infection would be mild in 9-10 % cases may go unnoticed

16. Manifestations of the urogenital system Circinate balanitis is characteristic. Circinate balanitis is defined by circinate or gyrate white plaques that grow centrifugally and eventually cover the entire surface of the glans penis. The penile shaft and scrotum can be involved. The lesions become rapidly keratotic in a circumcised penis. Circinate vulvitis is reported in women. Prostatitis, cystitis, and pyelonephritis are rare but possible urogenital manifestations of reactive arthritis. Bartholinitis can be present in women. Proctitis caused by Chlamydia species can occur in both sexes after anal intercourse.

17. Conjunctivitis Eye involvement is common. Conjunctivitis appears in approximately 50% of patients with reactive arthritis. Conjunctivitis is often bilateral, and it may be overlooked because of its transitory course. An intense red, velvetlike conjunctival injection characterizes the conjunctivitis. Edema and a purulent discharge are not rare in reactive arthritis–associated conjunctivitis.

18. Other ocular manifestations Iritis, iridocyclitis, and uveitis are seldom reported. Iritis is more common in late recurrent episodes, and it only occurs in 3-8% of patients in the first attack. At clinical examination, redness, pain, impaired vision, and exudation with hypopyon can suggest iritis. Recurrent episodes can lead to pupillary synechia and glaucoma. Keratitis rarely is reported.

20. Enthesopathy (ie, inflammation at the tendinous insertion into bone) is common in reactive arthritis and in other seronegative arthritides (eg, plantar fasciitis, digital periostitis, Achilles tendinitis).