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Reactive Arthritis A006

Date published 
Monday, June 15, 2015
Last amended 
Monday, October 29, 2018

Current RMA Instruments

Reasonable Hypothesis SOP [1]

75 of 2018

Balance of Probabilities SOP [2]

76 of 2018

Changes from previous Instruments

SOP Bulletin 204 [3]

ICD Coding

  • ICD-9-CM Codes: 099.3, 711.10-711.19, 372.33
  • ICD-10-AM Codes: M02

Brief description

Reactive arthritis is an immune reaction that typically presents as an acute onset arthritis that develops between several days and around 4 weeks after an infection elsewhere in the body.  The arthritis usually asymmetrically involves one or a few joints, most commonly in the lower limbs.  The preceding infection typically affects the digestive tract (dysentery) or the urogenital tract (urethritis).  There may be other musculoskeletal symptoms and extra-articular manifestations, involving the eyes, mucosa and skin.

Confirming the diagnosis

The diagnosis is made based on the clinical findings and by the exclusion of other diseases and can be made by a GP.  A range of investigations may be needed, including examination/testing of joint fluid, blood testing and testing for urinary or gastrointestinal infection.

The relevant medical specialist is a rheumatologist.

Additional diagnoses covered by SOP

  • Reiter’s syndrome

Conditions not covered by SOP

  • Lyme disease*
  • Leptospirosis*
  • Septic arthritis#
  • Post-streptococcal reactive arthritis#
  • Rheumatic fever#
  • Arthritis due to Ross river virus*
  • Arthritis due to Barmah forest virus#
  • Arthritis due to Rubella virus#
  • Arthritis due to parvovirus#

* another SOP applies

#   non-SOP condition

Clinical onset

Reactive arthritis is a relatively rare condition that mostly affects young adults.  The usual clinical onset is an acute asymmetric oligoarthritis that almost always develops between a few days and four weeks after the inciting infection.

Clinical worsening

The typical disease duration is 3 to 5 months.  A small proportion of patients may experience more chronic persisting arthritis. The only SOP worsening factor is for inability to obtain appropriate clinical management.

 

Rulebase for reactive arthritis

Place holder node for Rulebase for reactive arthritis

Enteric bacterial infection

Reactive arthritis - Enteric bacterial infection Factor

Last reviewed for CCPS 14 December 1998.

Preliminary questions [6835]

6836 [5] the veteran has suffered from an enteric bacterial infection at some time.

6837 — the veteran has established the causal connection between the enteric bacterial infection and VEA service for Reiter's syndrome.

6839 — the veteran has established the causal connection between the enteric bacterial infection and VEA service for the clinical onset of Reiter's syndrome.

6846 — the veteran has established the causal connection between the enteric bacterial infection and operational service for the clinical onset of Reiter's syndrome.

or

6847 — the veteran has established the causal connection between the enteric bacterial infection and eligible service for the clinical onset of Reiter's syndrome.

or

6840 [6] the clinical onset of Reiter's syndrome occurred after the end of the veteran's last period of VEA service.

[7]6841

the veteran's Reiter's syndrome permanently worsened.

6843 — the veteran has established the causal connection between the enteric bacterial infection and VEA service for the clinical worsening of Reiter's syndrome.

6850 — the veteran has established the causal connection between the enteric bacterial infection and operational service for the clinical worsening of Reiter's syndrome.

or

6851 — the veteran has established the causal connection between the enteric bacterial infection and eligible service for the clinical worsening of Reiter's syndrome.

Clinical onset and operational service [6846]

[8]6844

the veteran suffered from an enteric bacterial infection within the 60 days prior to the clinical onset of Reiter's syndrome.

[9]6853

the veteran contracted an enteric bacterial infection, suffered within the 60 days prior to the clinical onset of Reiter's syndrome, on operational service.

[10]6856

the enteric bacterial infection contracted on operational service, which the veteran suffered from within the 60 days prior to the clinical onset of Reiter's syndrome, was due to the veteran's serious default, wilful act or serious breach of discipline.

Clinical onset and eligible service [6847]

[11]6845

the veteran suffered from an enteric bacterial infection within the 30 days prior to the clinical onset of Reiter's syndrome.

[12]6854

the veteran contracted an enteric bacterial infection, suffered within the 30 days prior to the clinical onset of Reiter's syndrome, on eligible service.

[13]6855

the veteran contracted the enteric bacterial infection, suffered within the 30 days prior to the clinical onset of Reiter's syndrome, on eligible service, in the course of eligible service duties.

[14]6857

the enteric bacterial infection contracted on eligible service, which the veteran suffered from within the 30 days prior to the clinical onset of Reiter's syndrome, was due to the veteran's serious default, wilful act or serious breach of discipline.

Clinical worsening and operational service [6850]

[11]6848

the veteran suffered from an enteric bacterial infection within the 60 days prior to the clinical worsening of Reiter's syndrome.

[15]6859

the veteran contracted an enteric bacterial infection, suffered within the 60 days prior to the clinical worsening of Reiter's syndrome, on operational service.

[16]25274

the veteran contracted the enteric bacterial infection, suffered within the 60 days prior to the clinical worsening of Reiter's syndrome, on operational service, in the course of operational service duties.

[17]6860

the enteric bacterial infection contracted on operational service, which the veteran suffered from within the 60 days prior to the clinical worsening of Reiter's syndrome, was due to the veteran's serious default, wilful act or serious breach of discipline.

Clinical worsening and eligible service [6851]

[11]6849

the veteran suffered from an enteric bacterial infection within the 30 days prior to the clinical worsening of Reiter's syndrome.

[18]6861

the veteran contracted an enteric bacterial infection, suffered within the 30 days prior to the clinical worsening of Reiter's syndrome, on eligible service.

[19]6862

the veteran contracted the enteric bacterial infection, suffered within the 30 days prior to the clinical worsening of Reiter's syndrome, on eligible service, in the course of eligible service duties.

[20]6863

the enteric bacterial infection, which the veteran contracted on eligible service, within the 30 days prior to the clinical worsening of Reiter's syndrome, was due to the veteran's serious default, wilful act or serious breach of discipline. [11]

Inability to obtain appropriate clinical management for Reiter's syndrome

Reactive arthritis - Inability to obtain appropriate clinical management for Reiter's syndrome Factor

Last reviewed for CCPS 14 December 1998.

Investigative Documents

Medical Report - Inability to Obtain Appropriate Clinical Management - [GQACM]

Preliminary questions [5477]

[21]6900

there is some evidence that an inability to obtain appropriate clinical management for Reiter's syndrome may be a factor in the worsening of the condition under consideration.

6840 [6] the clinical onset of Reiter's syndrome occurred after the end of the veteran's last period of VEA service.

[7]6841

the veteran's Reiter's syndrome permanently worsened.

[8]6890

the veteran was unable to obtain appropriate clinical management for Reiter's syndrome at some time.

5484 [22] the inability to obtain appropriate clinical management for Reiter's syndrome contributed to the clinical worsening of the veteran's Reiter's syndrome.

5479 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for Reiter's syndrome and VEA service for the clinical worsening of Reiter's syndrome.

5480 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for Reiter's syndrome and operational service for the clinical worsening of Reiter's syndrome.

or

5481 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for Reiter's syndrome and eligible service for the clinical worsening of Reiter's syndrome.

Clinical worsening and operational service [5480]

[23]5483

the veteran was unable to obtain appropriate clinical management for Reiter's syndrome during operational service.

[24]16630

3 . the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of condition under consideration, during operational service, as a causal result of operational service duties.

[25]5485

the veteran's inability to obtain appropriate clinical management for Reiter's syndrome during operational service was due to the veteran's serious default, wilful act or serious breach of discipline.

or

[11]6893

the veteran was unable to obtain appropriate clinical management for Reiter's syndrome because of an illness or injury which is identifiable.

6894 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for Reiter's syndrome is causally related to operational service. [26] [27]

[28]6896

the clinical onset of Reiter's syndrome occurred prior to that part of operational service to which the identified illness or injury that prevented the veteran from obtaining appropriate clinical management for Reiter's syndrome is causally related.

Clinical worsening and eligible service [5481]

[29]5487

the veteran was unable to obtain appropriate clinical management for Reiter's syndrome during eligible service.

[30]6899

the veteran was unable to obtain appropriate clinical management for Reiter's syndrome during eligible service, as a causal result of eligible service duties.

[31]5489

the veteran's inability to obtain appropriate clinical management for Reiter's syndrome during eligible service was due to the veteran's serious default, wilful act or serious breach of discipline.

or

[11]6893

the veteran was unable to obtain appropriate clinical management for Reiter's syndrome because of an illness or injury which is identifiable.

6895 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for Reiter's syndrome is causally related to eligible service. [26] [27]

[32]6897

the clinical onset of Reiter's syndrome occurred prior to that part of eligible service to which the identified illness or injury that prevented the veteran from obtaining appropriate clinical management for Reiter's syndrome is causally related. [33]

Sexually acquired infection of the urethra

Reactive arthritis - Sexually acquired infection of the urethra Factor

Last reviewed for CCPS 14 December 1998.

Preliminary questions [6864]

6865 [34] the veteran has suffered from a sexually acquired infection of the urethra at some time.

6866 — the veteran has established the causal connection between the sexually acquired infection of the urethra and VEA service for Reiter's syndrome.

6868 — the veteran has established the causal connection between the sexually acquired infection of the urethra and VEA service for the clinical onset of Reiter's syndrome.

6872 — the veteran has established the causal connection between the sexually acquired infection of the urethra and operational service for the clinical onset of Reiter's syndrome.

or

6874 — the veteran has established the causal connection between the sexually acquired infection of the urethra and eligible service for the clinical onset of Reiter's syndrome.

or

6840 [6] the clinical onset of Reiter's syndrome occurred after the end of the veteran's last period of VEA service.

[7]6841

the veteran's Reiter's syndrome permanently worsened.

6870 — the veteran has established the causal connection between the sexually acquired infection of the urethra and VEA service for the clinical worsening of Reiter's syndrome.

6876 — the veteran has established the causal connection between the sexually acquired infection of the urethra and operational service for the clinical worsening of Reiter's syndrome.

or

6878 — the veteran has established the causal connection between the sexually acquired infection of the urethra and eligible service for the clinical worsening of Reiter's syndrome.

Clinical onset and operational service [6872]

[8]6871

the veteran suffered from a sexually acquired infection of the urethra within the 60 days prior to the clinical onset of Reiter's syndrome.

[35]6879

the veteran sexually acquired an infection of the urethra, suffered within the 60 days prior to the clinical onset of Reiter's syndrome, on operational service.

[36]32573

the veteran sexually acquired an infection of the urethra, suffered within the 60 days prior to the clinical onset of Reiter's syndrome, on operational service, in the course of operational service duties.

[37]6880

the sexual acquisition of the infection of the urethra on operational service, which the veteran suffered from within the 60 days prior to the clinical onset of Reiter's syndrome, was due to the veteran's serious default, wilful act or serious breach of discipline.

Clinical onset and eligible service [6874]

[11]6873

the veteran suffered from a sexually acquired infection of the urethra within the 30 days prior to the clinical onset of Reiter's syndrome.

[38]6881

the veteran sexually acquired an infection of the urethra, suffered within the 30 days prior to the clinical onset of Reiter's syndrome, on eligible service.

[39]6882

the veteran sexually acquired the infection of the urethra, suffered within the 30 days prior to the clinical onset of Reiter's syndrome, on eligible service, in the course of eligible service duties.

[40]6883

the sexual acquisition of the infection of the urethra on eligible service, which the veteran suffered from within the 30 days prior to the clinical onset of Reiter's syndrome, was due to the veteran's serious default, wilful act or serious breach of discipline.

Clinical worsening and operational service [6876]

[11]6875

the veteran suffered from a sexually acquired infection of the urethra within the 60 days prior to the clinical worsening of Reiter's syndrome.

[41]6885

the veteran sexually acquired an infection of the urethra, suffered within the 60 days prior to the clinical worsening of Reiter's syndrome, on operational service.

[42]25276

the veteran sexually acquired the infection of the urethra, suffered within the 60 days prior to the clinical worsening of Reiter's syndrome, on operational service, in the course of operational service duties.

[43]6886

the sexual acquisition of the infection of the urethra on operational service, which the veteran suffered from within the 60 days prior to the clinical worsening of Reiter's syndrome, was due to the veteran's serious default, wilful act or serious breach of discipline.

Clinical worsening and eligible service [6878]

[11]6877

the veteran suffered from a sexually acquired infection of the urethra within the 30 days prior to the clinical worsening of Reiter's syndrome.

[44]6887

the veteran sexually acquired the infection of the urethra, suffered within the 30 days prior to the clinical worsening of Reiter's syndrome, on eligible service.

[45]6888

the veteran sexually acquired the infection of the urethra, suffered within the 30 days prior to the clinical worsening of Reiter's syndrome, on eligible service, in the course of eligible service duties.

[46]6889

the sexual acquisition of the infection of the urethra on eligible service, which the veteran suffered from within the 30 days prior to the clinical worsening of Reiter's syndrome, was due to the veteran's serious default, wilful act or serious breach of discipline. [11]

Source URL (modified on 07/06/2019 - 7:43am): https://clik.dva.gov.au/ccps-medical-research-library/sops-grouped-icd-body-system/q-z/reactive-arthritis-a006-m02

Links
[1] http://www.rma.gov.au/assets/SOP/2018/075.pdf
[2] http://www.rma.gov.au/assets/SOP/2018/076.pdf
[3] https://clik.dva.gov.au/system/files/media/SOP%20Bulletin%20204.pdf
[4] https://clik.dva.gov.au/user/login?destination=comment/reply/64050%23comment-form
[5] https://clik.dva.gov.au/ccpsa006rc-4
[6] https://clik.dva.gov.au/node/71664
[7] clikpopup://CCPS/Reject/OnsetAfterService
[8] clikpopup://CCPS/Reject/NoPermanentWorsening
[9] clikpopup://CCPS/reject6844No
[10] clikpopup://CCPS/reject6853No
[11] clikpopup://CCPS/rejectwilful
[12] clikpopup://CCPS/reject6845No
[13] clikpopup://CCPS/reject6854No
[14] clikpopup://CCPS/reject6855No
[15] clikpopup://CCPS/reject6848No
[16] clikpopup://CCPS/reject6859No
[17] clikpopup://CCPS/reject25274No
[18] clikpopup://CCPS/reject6849No
[19] clikpopup://CCPS/reject6861No
[20] clikpopup://CCPS/reject6862No
[21] https://clik.dva.gov.au/ccpsother-31
[22] clikpopup://CCPS/Inability to obtain ACM contributed to worsening of Reiter's Syndrome
[23] clikpopup://CCPS/ACM/NoContribution
[24] clikpopup://CCPS/ACM/NotOpService
[25] clikpopup://CCPS/ACM/NotOperDuties
[26] clikpopup://CCPS/ACM/NoIllness
[27] clikpopup://CCPS/reject6894,6895No
[28] clikpopup://CCPS/Worsening of Reiter's syndrome op service req - inability to obtain ACM
[29] clikpopup://CCPS/ACM/OnsetFailOper
[30] clikpopup://CCPS/ACM/NotEligService
[31] clikpopup://CCPS/ACM/NotEligDuties
[32] clikpopup://CCPS/Worsening of Reiter's syndrome elig service req - inability to obtain ACM
[33] clikpopup://CCPS/ACM/OnsetFailElig
[34] https://clik.dva.gov.au/ccpsa006rc-0
[35] clikpopup://CCPS/reject6871No
[36] clikpopup://CCPS/reject6879No
[37] clikpopup://CCPS/reject32573No
[38] clikpopup://CCPS/reject6873No
[39] clikpopup://CCPS/reject6881No
[40] clikpopup://CCPS/reject6882No
[41] clikpopup://CCPS/reject6875No
[42] clikpopup://CCPS/reject6885No
[43] clikpopup://CCPS/reject25276No
[44] clikpopup://CCPS/reject6877No
[45] clikpopup://CCPS/reject6887No
[46] clikpopup://CCPS/reject6888No