ICD-10: M02.34

Reiter's disease, classified under ICD-10 code M02.34, is a specific type of reactive arthritis that is characterized by a triad of symptoms: arthritis, urethritis, and conjunctivitis. This condition is often associated with infections and can affect various joints, including the hands. Below are alternative names and related terms for Reiter's disease, particularly focusing on its manifestation in the hands.

Alternative Names for Reiter's Disease

1. Reactive Arthritis: This is the broader category under which Reiter's disease falls. Reactive arthritis occurs as a reaction to an infection in another part of the body, often the urogenital or gastrointestinal tract.

2. Post-Infectious Arthritis: This term emphasizes the condition's development following an infection, which is a key characteristic of Reiter's disease.

3. Urethritis-Associated Arthritis: This name highlights the connection between urethritis (inflammation of the urethra) and the arthritic symptoms seen in Reiter's disease.

4. Syndrome of Reiter: This term is sometimes used interchangeably with Reiter's disease, referring to the collection of symptoms associated with the condition.

5. Reiter's Syndrome: Similar to the above, this term is often used to describe the same condition, emphasizing the syndrome aspect of the disease.

Related Terms

1. Arthritis: A general term for inflammation of the joints, which is a primary symptom of Reiter's disease.

2. Conjunctivitis: Inflammation of the conjunctiva, often seen in conjunction with Reiter's disease.

3. Urethritis: Inflammation of the urethra, which is one of the hallmark symptoms of Reiter's disease.

4. Enthesitis: Inflammation at the site where tendons or ligaments insert into the bone, which can occur in Reiter's disease.

5. Sacroiliitis: Inflammation of the sacroiliac joints, which may also be associated with Reiter's disease.

6. HLA-B27 Positive: Many patients with Reiter's disease test positive for the HLA-B27 antigen, which is associated with several autoimmune conditions, including ankylosing spondylitis.

Conclusion

Reiter's disease (ICD-10 code M02.34) is a specific form of reactive arthritis that can significantly impact the hands and other joints. Understanding its alternative names and related terms can aid in better recognition and management of the condition. If you have further questions or need more detailed information about Reiter's disease or its treatment options, feel free to ask!

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 M02.34 specifically refers to Reiter's disease affecting the hand. 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 a triad of symptoms: arthritis, urethritis, and conjunctivitis. It is often triggered by infections, particularly those caused by certain bacteria such as Chlamydia trachomatis, Salmonella, Shigella, or Yersinia. The condition is classified under the broader category of reactive arthritis, which can manifest in various joints, including the hands.

Symptoms

The symptoms of Reiter's disease can vary but typically include:
- Joint Pain and Swelling: The most prominent feature is arthritis, which can affect one or multiple joints. In the case of M02.34, the hand is specifically involved, leading to pain, swelling, and stiffness in the fingers and wrists.
- Urethritis: Inflammation of the urethra, which may present as painful urination or discharge.
- Conjunctivitis: Inflammation of the eye, leading to redness, irritation, and discharge.
- Skin Manifestations: Some patients may develop skin rashes or lesions, particularly on the palms and soles.

Diagnosis

Diagnosis of Reiter's disease typically involves:
- Clinical Evaluation: A thorough history and physical examination to assess symptoms and joint involvement.
- Laboratory Tests: Blood tests may be conducted to check for markers of inflammation (such as ESR and CRP) and to rule out other conditions. Testing for the presence of triggering infections may also be performed.
- Imaging Studies: X-rays or MRI may be used to evaluate joint damage or inflammation.

Treatment

Management of Reiter's disease focuses on alleviating symptoms and addressing the underlying infection:
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): These are commonly prescribed to reduce pain and inflammation.
- Corticosteroids: In cases of severe inflammation, corticosteroids may be used to control symptoms.
- Antibiotics: If a bacterial infection is identified as the trigger, appropriate antibiotics will be administered.
- Physical Therapy: Rehabilitation exercises may help maintain joint function and mobility.

Prognosis

The prognosis for individuals with Reiter's disease varies. Some may experience a single episode that resolves completely, while others may have recurrent symptoms or chronic arthritis. Early diagnosis and treatment are crucial for improving outcomes and preventing long-term joint damage.

Conclusion

ICD-10 code M02.34 specifically identifies Reiter's disease affecting the hand, highlighting the importance of recognizing this condition in clinical practice. Understanding its symptoms, diagnostic criteria, and treatment options is essential for effective management and improving patient quality of life. If you suspect Reiter's disease, a comprehensive evaluation by a healthcare professional is recommended to ensure appropriate care and intervention.

Reiter's disease, also known as reactive arthritis, is classified under the ICD-10 code M02.34. This condition is characterized by a triad of symptoms: arthritis, urethritis, and conjunctivitis, often following a genitourinary or gastrointestinal infection. The diagnosis of Reiter's disease involves several criteria, which can be categorized into clinical, laboratory, and imaging findings.

Clinical Criteria

1. Arthritis: The presence of inflammatory arthritis, typically affecting the lower extremities, but in this case, specifically noted in the hands. Symptoms may include swelling, pain, and stiffness in the joints.

2. Urethritis: A history of urethritis, which may present as dysuria (painful urination) or discharge. This symptom often follows a sexually transmitted infection.

3. Conjunctivitis: Ocular symptoms such as conjunctivitis or uveitis may also be present, although they are not always required for diagnosis.

4. Asymmetrical Joint Involvement: The arthritis is often asymmetrical, affecting different joints on either side of the body.

5. Skin Manifestations: Some patients may exhibit skin lesions, such as keratoderma blennorrhagicum or circinate balanitis.

Laboratory Criteria

1. HLA-B27 Antigen: Testing for the HLA-B27 antigen can support the diagnosis, as a significant percentage of patients with Reiter's disease test positive for this antigen.

2. Infection History: A documented history of a preceding infection, particularly with Chlamydia trachomatis or gastrointestinal pathogens like Salmonella, Shigella, or Campylobacter, is crucial.

3. Synovial Fluid Analysis: Analysis of synovial fluid from affected joints may show inflammatory changes, although this is not always definitive.

Imaging Criteria

1. X-ray Findings: Imaging studies may reveal changes consistent with inflammatory arthritis, such as joint effusion, erosions, or changes in bone density.

2. Ultrasound or MRI: These imaging modalities can help assess soft tissue involvement and detect early inflammatory changes in the joints.

Summary

The diagnosis of Reiter's disease (ICD-10 code M02.34) is primarily clinical, supported by laboratory and imaging findings. A thorough patient history, including previous infections and symptomatology, is essential for accurate diagnosis. The combination of arthritis, urethritis, and conjunctivitis, along with supportive laboratory tests, forms the basis for identifying this condition.

For further confirmation and management, referral to a rheumatologist may be beneficial, especially in complex cases or when the diagnosis is uncertain.

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 for Reiter's disease affecting the hand is M02.34. 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

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs are often the first line of treatment for Reiter's disease. They help reduce inflammation and relieve pain. Common NSAIDs include:
- Ibuprofen
- Naproxen
- Indomethacin

These medications can be effective in managing symptoms, especially during flare-ups of arthritis[1][2].

Corticosteroids

For patients who do not respond adequately to NSAIDs, corticosteroids may be prescribed. These can be administered orally or injected directly into the affected joints to provide rapid relief from inflammation. Common corticosteroids include:
- Prednisone
- Methylprednisolone

Corticosteroids are particularly useful for controlling severe symptoms or when multiple joints are involved[3][4].

Disease-Modifying Anti-Rheumatic Drugs (DMARDs)

In cases where Reiter's disease becomes chronic or does not respond to NSAIDs or corticosteroids, DMARDs may be considered. These medications help slow disease progression and prevent joint damage. Common DMARDs include:
- Methotrexate
- Sulfasalazine

These drugs are typically used in more severe cases or when there is a risk of long-term joint damage[5][6].

2. Physical Therapy

Physical therapy plays a crucial role in the management of Reiter's disease. A physical therapist can design a tailored exercise program to improve joint function, increase strength, and enhance flexibility. This can help mitigate stiffness and maintain mobility in the affected joints, particularly in the hands[7].

3. Lifestyle Modifications

Patients are often advised to make certain lifestyle changes to help manage their condition:
- Diet: A balanced diet rich in anti-inflammatory foods (such as omega-3 fatty acids) may help reduce inflammation.
- Exercise: Regular low-impact exercise can improve joint function and overall health.
- Weight Management: Maintaining a healthy weight can reduce stress on the joints, particularly in weight-bearing areas[8].

4. Management of Underlying Infections

Since Reiter's disease is often triggered by infections, it is essential to identify and treat any underlying infections. This may involve:
- Antibiotics for bacterial infections
- Antiviral medications if a viral infection is present

Addressing these infections can help alleviate the symptoms of Reiter's disease and prevent further complications[9].

5. Alternative Therapies

Some patients may explore alternative therapies, such as acupuncture or dietary supplements (like glucosamine and chondroitin), although the evidence supporting their effectiveness is variable. It is important for patients to discuss these options with their healthcare provider to ensure they are safe and appropriate for their condition[10].

Conclusion

The management of Reiter's disease, particularly when it affects the hand, involves a multifaceted approach that includes medications, physical therapy, lifestyle modifications, and addressing any underlying infections. Early intervention and a tailored treatment plan can significantly improve outcomes and enhance the quality of life for individuals affected by this condition. Patients should work closely with their healthcare providers to develop a comprehensive management strategy that suits their specific needs and circumstances.

Reiter's disease, also known as reactive arthritis, is classified under ICD-10 code M02.34. This condition is characterized by a triad of symptoms: arthritis, urethritis, and conjunctivitis, often following a genitourinary or gastrointestinal infection. Below is a detailed overview of the clinical presentation, signs, symptoms, and patient characteristics associated with Reiter's disease, particularly focusing on its manifestation in the hands.

Clinical Presentation

Overview of Reiter's Disease

Reiter's disease is a type of inflammatory arthritis that typically arises as a reaction to an infection elsewhere in the body. It is most commonly triggered by infections such as Chlamydia trachomatis (genitourinary) or certain gastrointestinal pathogens like Salmonella, Shigella, or Campylobacter. The onset of symptoms usually occurs within one to four weeks after the initial infection.

Signs and Symptoms

1. Arthritis:
   - Joint Involvement: The disease often affects the lower extremities, but in cases where the hands are involved, patients may experience:

   • Swelling and pain in the fingers and wrists.
   • Morning stiffness that improves with activity.
   • Asymmetrical joint involvement, meaning not all joints are affected equally.
   • Dactylitis: This is a notable feature where an entire finger or toe becomes swollen, resembling a "sausage" shape.

2. Urethritis:
   - Patients may report symptoms of urethritis, including:

   • Painful urination (dysuria).
   • Increased frequency of urination.
   • Discharge from the urethra.

3. Conjunctivitis:
   - Ocular symptoms may include:

   • Redness and irritation of the eyes.
   • Sensitivity to light (photophobia).
   • Discharge from the eyes.

4. Skin Manifestations:
   - Some patients may develop skin lesions, such as:

   • Keratoderma blennorrhagicum (scaly, red-brown patches).
   • Circinate balanitis (lesions on the glans penis).

5. Systemic Symptoms:
   - Fatigue and malaise are common.
   - Fever may occur, although it is not always present.

Patient Characteristics

• Demographics:

• Reiter's disease is more prevalent in young adults, particularly males aged 20 to 40 years. However, it can occur in both genders and at any age.

• Risk Factors:

• A history of sexually transmitted infections or gastrointestinal infections increases the risk of developing Reiter's disease.

• Genetic predisposition may play a role, as the HLA-B27 antigen is found in a significant proportion of affected individuals.

• Comorbidities:

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

Conclusion

Reiter's disease, classified under ICD-10 code M02.34, presents with a distinct set of symptoms primarily affecting the joints, including the hands, as well as the urogenital and ocular systems. The clinical presentation is characterized by arthritis, urethritis, and conjunctivitis, often following an infection. Understanding the signs, symptoms, and patient characteristics is crucial for timely diagnosis and management of this condition. Early intervention can help mitigate the impact of the disease on the patient's quality of life and prevent long-term joint damage.