M02.342

Clinical Causes: Bacterial infections, commonly from gastrointestinal or genitourinary sources, such as Salmonella, Shigella, Yersinia, and Chlamydia trachomatis. Genetic predisposition, particularly the presence of the HLA-B27 gene. Immune system reactions triggered by bacterial infections, leading to inflammation in the joints and other tissues.

Key Symptoms: Joint pain and swelling in the left hand Stiffness, especially after periods of inactivity Warmth and redness over affected joints Enthesitis, or inflammation where tendons and ligaments attach to bones Possible skin lesions, such as keratoderma blenorrhagicum or circinate balanitis Urethritis or urinary discomfort may be present Fatigue and general malaise

Diagnosis Path: Diagnosis involves a combination of clinical examination, patient history, and laboratory tests. Key steps include: - Reviewing recent infections and symptoms - Blood tests to detect inflammation markers and the presence of the HLA-B27 gene - Synovial fluid analysis from affected joints to rule out other causes - Imaging studies, such as X-rays, to assess joint damage or inflammation - Exclusion of other types of arthritis, like rheumatoid arthritis or gout The diagnosis is often based on the presence of characteristic symptoms and supporting laboratory findings.

Treatment Protocols: Treatment aims to reduce inflammation, relieve symptoms, and prevent joint damage. Strategies include: - Nonsteroidal anti-inflammatory drugs (NSAIDs) to control pain and swelling - Disease-modifying antirheumatic drugs (DMARDs) in persistent cases - Physical therapy and joint exercises to maintain mobility - Rest and joint rest during acute phases - Antibiotic therapy if an ongoing infection is identified - Corticosteroids, either systemic or local, for severe inflammation - Patient education on managing symptoms and preventing triggers Supportive measures, such as warm compresses and ergonomic adjustments, may also be recommended to enhance comfort.