ICD-10: M02.312

Reiter's disease, also known as reactive arthritis, is a type of inflammatory arthritis that can occur as a reaction to an infection in another part of the body. The ICD-10-CM code M02.312 specifically refers to Reiter's disease affecting the left shoulder. Below is a detailed clinical description and relevant information regarding this condition.

Clinical Description of Reiter's Disease

Definition

Reiter's disease is characterized by the triad of arthritis, urethritis, and conjunctivitis, although not all patients exhibit all three symptoms. It is often triggered by infections, particularly those caused by certain bacteria, such as Chlamydia trachomatis, Salmonella, Shigella, or Yersinia.

Symptoms

Patients with Reiter's disease may experience:
- Joint Pain and Swelling: The left shoulder, in this case, may exhibit significant pain, swelling, and stiffness, which can limit mobility.
- Urethritis: Inflammation of the urethra, leading to painful urination or discharge.
- Conjunctivitis: Inflammation of the eye, which may cause redness, irritation, and discharge.
- Skin Manifestations: Some patients may develop skin rashes or lesions.

Pathophysiology

The exact mechanism of Reiter's disease is not fully understood, but it is believed to involve an autoimmune response triggered by an infection. The body’s immune system mistakenly attacks its own joint tissues, leading to inflammation and pain.

ICD-10 Code M02.312: Specifics

Code Details

• ICD-10 Code: M02.312
• Description: Reiter's disease, left shoulder
• Billable Code: This code is billable, meaning it can be used for insurance claims and medical billing purposes.

Related Codes

• M02.3: General code for Reiter's disease.
• M02.31: Reiter's disease affecting the shoulder (unspecified).
• M02.311: Reiter's disease, right shoulder.

Clinical Implications

When coding for Reiter's disease, it is essential to specify the affected joint to ensure accurate diagnosis and treatment. The left shoulder involvement may require targeted therapeutic interventions, such as physical therapy, anti-inflammatory medications, or corticosteroids to manage symptoms and improve joint function.

Diagnosis and Management

Diagnosis

Diagnosis typically involves:
- Clinical Evaluation: Assessment of symptoms and medical history.
- Laboratory Tests: Blood tests to check for markers of inflammation and possible infections.
- Imaging Studies: X-rays or MRI may be used to assess joint damage or inflammation.

Management

Management strategies may include:
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief, disease-modifying antirheumatic drugs (DMARDs) in chronic cases, and antibiotics if an underlying infection is present.
- Physical Therapy: To improve joint function and reduce stiffness.
- Lifestyle Modifications: Including exercise and dietary changes to support overall joint health.

Conclusion

Reiter's disease, particularly when affecting the left shoulder, requires careful diagnosis and management to alleviate symptoms and prevent long-term joint damage. The ICD-10 code M02.312 is crucial for accurate medical billing and documentation, ensuring that patients receive appropriate care tailored to their specific condition. Understanding the clinical implications and treatment options is essential for healthcare providers managing patients with this condition.

Reiter's disease, also known as reactive arthritis, is a type of inflammatory arthritis that can occur following an infection, particularly in the urogenital or gastrointestinal tract. The ICD-10 code M02.312 specifically refers to Reiter's disease affecting the left shoulder. Below is a detailed overview of the clinical presentation, signs, symptoms, and patient characteristics associated with this condition.

Clinical Presentation

Overview of Reiter's Disease

Reiter's disease is characterized by a triad of symptoms: arthritis, urethritis, and conjunctivitis. However, not all patients will present with all three symptoms. The condition is often triggered by infections, particularly those caused by Chlamydia trachomatis, Salmonella, Shigella, or Yersinia species.

Signs and Symptoms

1. Arthritis:
   - Joint Involvement: The left shoulder may exhibit swelling, tenderness, and pain, which can limit the range of motion. Other joints, such as the knees, ankles, and feet, may also be affected.
   - Asymmetrical Involvement: Joint involvement is often asymmetrical, meaning that not all joints are affected equally.

2. Urethritis:
   - Patients may experience symptoms of urethritis, including painful urination, discharge, and increased frequency of urination.

3. Conjunctivitis:
   - Eye symptoms may include redness, irritation, and discharge, indicating inflammation of the conjunctiva.

4. Skin Manifestations:
   - Some patients may develop skin lesions, such as keratoderma blennorrhagicum, which are scaly and can appear on the palms and soles.

5. Systemic Symptoms:
   - Patients may also report systemic symptoms such as fever, fatigue, and malaise, particularly during the acute phase of the disease.

Patient Characteristics

• Demographics:

• Reiter's disease is more common in young adults, particularly males aged 20 to 40 years. However, it can occur in individuals of any age and gender.

• History of Infection:

• A significant number of patients report a recent history of genitourinary or gastrointestinal infections prior to the onset of arthritis symptoms.

• Genetic Factors:

• There is a notable association with the HLA-B27 antigen, which is present in a higher percentage of individuals with Reiter's disease compared to the general population.

• Comorbid Conditions:

• Patients may have other autoimmune conditions or a history of inflammatory diseases, which can complicate the clinical picture.

Conclusion

Reiter's disease, particularly when affecting the left shoulder as indicated by the ICD-10 code M02.312, presents with a combination of joint pain, potential urethritis, and conjunctivitis, often following an infection. Understanding the clinical presentation and patient characteristics is crucial for timely diagnosis and management. Early intervention can help alleviate symptoms and prevent long-term joint damage, making awareness of this condition essential for healthcare providers.

Reiter's disease, also known as reactive arthritis, is a condition characterized by inflammation of the joints, often following an infection. The ICD-10 code M02.312 specifically refers to Reiter's disease affecting the left shoulder. Here are some alternative names and related terms associated with this condition:

Alternative Names

1. Reactive Arthritis: This is the most common alternative name for Reiter's disease, emphasizing its association with preceding infections.
2. Postinfectious Arthritis: This term highlights the condition's development following an infection.
3. Reiter's Syndrome: This name is often used interchangeably with Reiter's disease, although it can sometimes refer to a broader set of symptoms, including urethritis and conjunctivitis.
4. Urethritis-Associated Arthritis: This term is used when the arthritis is linked to urethritis, a common symptom in Reiter's disease.

Related Terms

1. Spondyloarthritis: A group of inflammatory diseases that includes reactive arthritis, characterized by inflammation of the spine and joints.
2. Arthritis: A general term for inflammation of the joints, which encompasses various types, including Reiter's disease.
3. Enthesitis: Inflammation at the site where tendons or ligaments insert into the bone, which can occur in reactive arthritis.
4. Dactylitis: Swelling of an entire finger or toe, which can be a symptom of reactive arthritis.
5. HLA-B27: A genetic marker often associated with reactive arthritis and other spondyloarthropathies.

Conclusion

Understanding the alternative names and related terms for ICD-10 code M02.312 can enhance communication among healthcare providers and improve patient education. Recognizing these terms is crucial for accurate diagnosis and treatment planning, especially in cases where the condition may be linked to other inflammatory or infectious processes.

Reiter's disease, also known as reactive arthritis, is characterized by a triad of symptoms: arthritis, urethritis, and conjunctivitis. The diagnosis of Reiter's disease, particularly when associated with a specific joint like the left shoulder (ICD-10 code M02.312), involves several criteria and considerations.

Diagnostic Criteria for Reiter's Disease

1. Clinical Symptoms

The diagnosis typically requires the presence of the following clinical features:

• Arthritis: Inflammation of the joints, which may present as pain, swelling, and stiffness. In the case of M02.312, the left shoulder is specifically affected.
• Urethritis: Inflammation of the urethra, often presenting with dysuria or urethral discharge.
• Conjunctivitis: Inflammation of the conjunctiva, leading to redness and irritation of the eyes.

2. History of Preceding Infection

Reiter's disease often follows a genitourinary or gastrointestinal infection. A history of such infections, particularly with pathogens like Chlamydia trachomatis or certain strains of Salmonella, Shigella, or Yersinia, can support the diagnosis.

3. Exclusion of Other Conditions

To confirm a diagnosis of Reiter's disease, it is essential to rule out other forms of arthritis, such as:

• Rheumatoid arthritis
• Psoriatic arthritis
• Gout
• Other reactive arthropathies

4. Laboratory Tests

While there are no definitive laboratory tests for Reiter's disease, certain tests can aid in the diagnosis:

• HLA-B27 Antigen Testing: A significant percentage of patients with Reiter's disease test positive for this antigen, although it is not exclusive to the condition.
• Synovial Fluid Analysis: In cases where joint effusion is present, analyzing the synovial fluid can help rule out other causes of arthritis.

5. Imaging Studies

Imaging, such as X-rays or MRI, may be utilized to assess joint involvement and rule out other conditions. In the case of the left shoulder, imaging can help visualize any joint damage or inflammation.

Conclusion

The diagnosis of Reiter's disease, particularly for the left shoulder (ICD-10 code M02.312), is based on a combination of clinical symptoms, history of preceding infections, exclusion of other arthritic conditions, and supportive laboratory and imaging findings. A thorough evaluation by a healthcare professional is essential to ensure an accurate diagnosis and appropriate management.

Reiter's disease, also known as reactive arthritis, is a type of inflammatory arthritis that can occur following an infection, particularly in the urogenital or gastrointestinal tract. The ICD-10 code M02.312 specifically refers to Reiter's disease affecting the left shoulder. Treatment approaches for this condition typically focus on alleviating symptoms, managing inflammation, and addressing any underlying infections. Below is a detailed overview of standard treatment strategies.

Standard Treatment Approaches

1. Medications

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs are often the first line of treatment for managing pain and inflammation associated with Reiter's disease. Commonly used NSAIDs include ibuprofen and naproxen. These medications help reduce swelling and discomfort in the affected joints, including the shoulder[1].

Corticosteroids

In cases where NSAIDs are insufficient, corticosteroids may be prescribed. These can be administered orally or injected directly into the affected joint to provide rapid relief from inflammation and pain. Corticosteroids are particularly useful for acute flare-ups of the disease[2].

Disease-Modifying Antirheumatic Drugs (DMARDs)

For patients with persistent symptoms or those who do not respond adequately to NSAIDs or corticosteroids, DMARDs such as methotrexate may be considered. These medications help slow the progression of the disease and prevent joint damage over time[3].

2. Physical Therapy

Physical therapy plays a crucial role in the rehabilitation of patients with Reiter's disease. A physical therapist can design a tailored exercise program to improve joint function, increase strength, and enhance flexibility in the shoulder. This may include stretching exercises, strengthening routines, and modalities such as ultrasound or electrical stimulation to alleviate pain[4].

3. Management of Underlying Infections

Since Reiter's disease is often triggered by infections, it is essential to identify and treat any underlying infections. Antibiotics may be necessary if a bacterial infection is present. Addressing the infection can help reduce the inflammatory response and improve overall symptoms[5].

4. Lifestyle Modifications

Patients are encouraged to adopt lifestyle changes that can help manage symptoms and improve overall health. This includes:
- Regular Exercise: Engaging in low-impact activities such as swimming or cycling can help maintain joint function and reduce stiffness.
- Healthy Diet: A balanced diet rich in anti-inflammatory foods (e.g., fruits, vegetables, whole grains, and omega-3 fatty acids) may help manage inflammation.
- Weight Management: Maintaining a healthy weight can reduce stress on the joints, particularly in weight-bearing areas[6].

5. Alternative Therapies

Some patients may find relief through alternative therapies such as acupuncture, massage therapy, or the use of hot/cold compresses. While these methods may not be universally effective, they can provide additional comfort and symptom relief for some individuals[7].

Conclusion

The management of Reiter's disease, particularly when it affects the left shoulder (ICD-10 code M02.312), involves a multifaceted approach that includes medication, physical therapy, and lifestyle modifications. Early intervention and a tailored treatment plan can significantly improve outcomes and enhance the quality of life for affected individuals. If symptoms persist or worsen, it is crucial to consult a healthcare professional for further evaluation and management options.