ICD-10: M02.351

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 M02.351 specifically refers to Reiter's disease affecting the right hip. 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 Chlamydia trachomatis, Salmonella, Shigella, or Yersinia species. The condition is more common in young adults and can affect both genders, although it is more prevalent in males.

Symptoms

• Arthritis: The primary symptom, which can affect one or multiple joints. In the case of M02.351, the right hip is specifically involved. Patients may experience pain, swelling, and stiffness in the hip joint.
• Urethritis: Inflammation of the urethra, leading to painful urination and discharge.
• Conjunctivitis: Inflammation of the eye, which may cause redness, irritation, and discharge.

Pathophysiology

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

Diagnosis

Diagnosis is primarily clinical, based on the presence of the characteristic symptoms and a history of preceding infections. Laboratory tests may include:
- Blood tests: To check for markers of inflammation (e.g., ESR, CRP) and to rule out other conditions.
- Joint fluid analysis: To exclude other types of arthritis, such as gout or septic arthritis.
- Microbiological tests: To identify any underlying infections.

Treatment

Management of Reiter's disease focuses on relieving symptoms and addressing the underlying infection. Treatment options may include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): To reduce pain and inflammation.
- Corticosteroids: For more severe inflammation.
- Disease-modifying antirheumatic drugs (DMARDs): In chronic cases that do not respond to NSAIDs.
- Antibiotics: If a bacterial infection is identified.

Prognosis

The prognosis for Reiter's disease varies. Some patients 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.

ICD-10 Code Details

Code: M02.351

• Description: Reiter's disease, right hip.
• Classification: This code falls under the category of inflammatory arthritis due to infectious agents, specifically reactive arthritis.
• Billable Code: M02.351 is a billable code, meaning it can be used for reimbursement purposes in medical billing.

Related Codes

• M02.35: Reiter's disease, unspecified site.
• M02.352: Reiter's disease, left hip.

Conclusion

Reiter's disease, particularly when affecting the right hip as indicated by ICD-10 code M02.351, is a significant condition that requires careful diagnosis and management. Understanding its clinical presentation, potential triggers, and treatment options is essential for healthcare providers to effectively address the needs of affected patients. Early intervention can lead to better outcomes and improved quality of life for those suffering from 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-CM code M02.351 specifically refers to Reiter's disease affecting the right hip. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this condition is crucial for accurate diagnosis and management.

Clinical Presentation

Reiter's disease typically presents with a triad of symptoms: arthritis, urethritis, and conjunctivitis. However, not all patients will exhibit all three symptoms. The clinical presentation can vary significantly among individuals, and the onset may occur weeks to months after the triggering infection.

Key Features

1. Arthritis:
   - The most prominent feature, often affecting the lower extremities, including the knees, ankles, and feet, but in this case, specifically the right hip.
   - Joint pain may be asymmetric and can be accompanied by swelling and tenderness.

2. Urethritis:
   - Patients may experience dysuria (painful urination) or urethral discharge, indicating inflammation of the urethra.

3. Conjunctivitis:
   - Ocular symptoms may include redness, irritation, and discharge from the eyes, although this is less common.

4. Skin Manifestations:
   - Some patients may develop skin lesions, such as keratoderma blennorrhagicum (scaly, red-brown patches) or circinate balanitis (a rash on the glans penis).

5. Systemic Symptoms:
   - Fatigue, malaise, and low-grade fever may also be present, reflecting the inflammatory nature of the disease.

Signs and Symptoms

Common Symptoms

• Joint Symptoms:
• Pain and stiffness in the right hip, which may worsen with activity and improve with rest.

• Swelling and warmth over the affected joint.

• Urogenital Symptoms:

• Symptoms of urethritis, including burning sensation during urination and possible discharge.

• Ocular Symptoms:

• Redness and discomfort in the eyes, potentially leading to photophobia.

Physical Examination Findings

• Joint Examination:
• Tenderness and swelling in the right hip joint.

• Limited range of motion due to pain.

• Skin Examination:

• Presence of skin lesions, if applicable.

• Ocular Examination:

• Signs of conjunctivitis or other eye-related issues.

Patient Characteristics

Demographics

• Age:

• Most commonly affects young adults, particularly those aged 20 to 40 years.

• Gender:

• More prevalent in males than females, particularly in cases associated with urogenital infections.

Risk Factors

• Infections:

• Recent history of gastrointestinal infections (e.g., Salmonella, Shigella) or urogenital infections (e.g., Chlamydia trachomatis).

• Genetic Predisposition:

• A higher incidence in individuals with the HLA-B27 antigen, which is associated with various spondyloarthropathies.

Comorbidities

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

Conclusion

Reiter's disease, particularly when affecting the right hip as indicated by ICD-10 code M02.351, presents with a combination of joint pain, potential urogenital symptoms, and ocular involvement. Recognizing the clinical features and patient characteristics is essential for timely diagnosis and effective management. Early intervention can help alleviate symptoms and prevent long-term joint damage, emphasizing the importance of a thorough clinical evaluation in affected individuals.

Reiter's disease, classified under the ICD-10 code M02.351, is a form of reactive arthritis that typically arises following an infection. It is characterized by a triad of symptoms: arthritis, urethritis, and conjunctivitis. While "Reiter's disease" is the most commonly used term, there are several alternative names and related terms that are associated with this condition.

Alternative Names for Reiter's Disease

1. Reactive Arthritis: This is the most widely accepted term today, as it reflects the condition's nature of occurring in response to an infection elsewhere in the body, rather than being a primary disease itself[1].

2. Postinfectious Arthritis: This term emphasizes the condition's development following an infection, which can be caused by various pathogens, including bacteria and viruses[2].

3. Urethritis-Associated Arthritis: This name highlights the common symptom of urethritis that often accompanies the arthritis seen in Reiter's disease[3].

4. Syndrome of Reiter: This term is sometimes used to describe the combination of symptoms associated with the disease, including arthritis, urethritis, and conjunctivitis[4].

5. Reiter's Syndrome: Although less common, this term is still used interchangeably with Reiter's disease, particularly in older literature[5].

Related Terms

1. 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 and other spondyloarthropathies[6].

2. Arthritis: A general term that refers to inflammation of the joints, which is a primary symptom of Reiter's disease[7].

3. Conjunctivitis: This term refers to the inflammation of the conjunctiva, which is one of the hallmark symptoms of Reiter's disease[8].

4. Urethritis: Inflammation of the urethra, another key symptom that often presents alongside arthritis in patients with Reiter's disease[9].

5. Spondyloarthritis: A broader category of inflammatory arthritis that includes conditions like Reiter's disease, ankylosing spondylitis, and psoriatic arthritis, characterized by inflammation of the spine and the joints[10].

Conclusion

Understanding the alternative names and related terms for Reiter's disease can enhance communication among healthcare providers and improve patient education. The shift towards using "reactive arthritis" reflects a broader understanding of the condition's etiology and its relationship with infections. As medical terminology evolves, it is essential to stay informed about these changes to ensure accurate diagnosis and treatment.

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 M02.351 specifically refers to Reiter's disease affecting the right hip. The diagnosis of Reiter's disease involves several criteria, which can be categorized into clinical, laboratory, and imaging findings.

Clinical Criteria

1. History of Infection: A recent history of a genitourinary or gastrointestinal infection is often noted. Common pathogens include Chlamydia trachomatis, Salmonella, Shigella, and Campylobacter.

2. Arthritis Symptoms: Patients typically present with:
   - Asymmetrical oligoarthritis, often affecting the lower extremities.
   - Pain and swelling in the affected joints, particularly the right hip in this case.
   - Morning stiffness that improves with activity.

3. Extra-Articular Manifestations: These may include:
   - Conjunctivitis or uveitis.
   - Urethritis or cervicitis.
   - Skin lesions, such as keratoderma blennorrhagicum or circinate balanitis.

Laboratory Criteria

1. Serological Tests: While there is no specific test for Reiter's disease, the following may be performed:
   - HLA-B27 Antigen: A significant percentage of patients with Reiter's disease test positive for this antigen, although it is not definitive for diagnosis.
   - Increased Inflammatory Markers: Elevated levels of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) may indicate inflammation.

2. Microbiological Tests: Testing for the presence of the pathogens associated with the preceding infection can support the diagnosis, although they may not always be positive.

Imaging Criteria

1. X-rays: Imaging studies of the affected joint (in this case, the right hip) may show:
   - Joint effusion.
   - Erosions or changes in bone density.
   - Signs of enthesitis (inflammation at the site where tendons or ligaments insert into the bone).

2. MRI or Ultrasound: These modalities can provide more detailed images of soft tissue and joint structures, helping to assess inflammation and joint damage.

Conclusion

The diagnosis of Reiter's disease (ICD-10 code M02.351) is primarily clinical, supported by laboratory and imaging findings. A thorough patient history, including recent infections and the presence of characteristic symptoms, is essential for accurate diagnosis. If you suspect Reiter's disease, it is crucial to consult a healthcare professional for a comprehensive evaluation 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 M02.351 specifically refers to Reiter's disease affecting the right hip. 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
- Naproxen
- Indomethacin

These medications help reduce swelling and relieve pain, making them essential in the initial management of symptoms[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. Common corticosteroids include:
- Prednisone
- Methylprednisolone

Corticosteroids are particularly useful for patients with severe symptoms or those who do not respond to NSAIDs[2].

Disease-Modifying Antirheumatic Drugs (DMARDs)

For chronic cases or when joint damage is a concern, DMARDs may be introduced. These medications help slow disease progression and prevent joint damage. Common DMARDs include:
- Methotrexate
- Sulfasalazine

These are typically considered when symptoms persist despite NSAID and corticosteroid treatment[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 mobility
- Strengthen surrounding muscles
- Reduce stiffness

Therapeutic exercises can help maintain function and prevent long-term disability associated with joint inflammation[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. This may involve:
- Antibiotics for bacterial infections
- Antiviral medications if a viral infection is suspected

Addressing the root cause can significantly improve the patient's overall condition and reduce the likelihood of recurrent arthritis episodes[5].

4. Lifestyle Modifications

Patients are encouraged to adopt lifestyle changes that can help manage symptoms and improve overall health. Recommendations may include:
- Regular exercise to maintain joint function
- Healthy diet to support immune function and reduce inflammation
- Weight management to decrease stress on weight-bearing joints

These modifications can enhance the effectiveness of medical treatments and improve quality of life[6].

5. Surgical Interventions

In rare cases where joint damage is severe and conservative treatments fail, surgical options may be considered. Procedures can include:
- Arthroscopy to remove inflamed tissue
- Joint replacement for severely damaged joints

Surgical interventions are typically reserved for cases with significant functional impairment or chronic pain[7].

Conclusion

The management of Reiter's disease, particularly when affecting the right hip (ICD-10 code M02.351), 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. Regular follow-up with healthcare providers is essential to monitor the condition and adjust treatment as necessary. If you have further questions or need more specific information, feel free to ask!