Abstract

The etiologic role that bacteria play in the genesis of arthritis is most clearly defined in reactive arthritis.

Tremendous recent insights into the pathophysiology of reactive arthritis have been made demonstrating that the causative bacteria play a much more complex role than previously thought.

The bacteria that are proven to cause reactive arthritis, one of the five types of spondyloarthritis, will be reviewed and their role in the pathophysiology of reactive arthritis will be examined.

Important differences in the pathophysiology of post-chlamydial reactive arthritis compared to the post-enteric variety exist, namely synovial based chlamydiae are viable, whereas the post-enteric organisms, in general, are not. However the phenotypic features are the same.

However, similar studies have also demonstrated synovial based bacteria in some patients with osteoarthritis and rarely even in normal controls.

The potential role that these synovial based bacteria play in disease maintenance and the potential eradication of these synovial based organsims will be discussed.