J Korean Orthop Assoc JKOA Journal of the Korean Orthopaedic Association 1226-2102 2005-8918 The Korean Orthopaedic Association 10.4055/jkoa.2013.48.3.236 Case Report Reactive Arthritis in a Patient with Chlamydia trachomatis Infection Lee Seoung Jun M.D. Ph.D. Lee Jun Gyu M.D. Department of Orthopaedic Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea. Correspondence to: Seoung Jun Lee, M.D., Ph.D. Department of Orthopaedic Surgery, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 143-729, Korea. TEL: +82-2-2030-7360, FAX: +82-2-2030-7369, lsjmd@naver.com 06 2013 24 06 2013 48 3 236 239 20 01 2013 19 02 2013 20 02 2013 Copyright © 2013 by The Korean Orthopaedic Association 2013 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

The authors report a case of reactive arthritis that was caused by sexual contact as below example. A 36-year-old male visited our center due to sudden pain in wrist joint, the 3rd finger, knee joint, and achilles tendon. There were no specific abnormalities for the immunoserologic tests and magnetic resonance imaging; however, we found a positive test result for the polymerase chain reaction test of urine that identified Chlamydia trachomatis. Through considering the patient's medical history and various examinations, we considered the possibility of reactive arthritis, to the exclusion of alternate diagnosis. According to the our diagnosis, the patient was treated with antibiotics and nonsteroidal anti-inflammatory drugs and we found that the patient was getting better. Therefore the authors think that we have to contemplate the possibility of reactive arthritis and treat appropriately in patients with similar symptoms.

 reactive arthritis previous infection multiple arthritic pain antibiotics therapy Moreland LW Koopman WJ Infection as a cause of reactive arthritis, ankylosing spondylitis, and rheumatic fever Curr Opin Rheumatol 1992 4 534 542 Carter JD Hudson AP Reactive arthritis: clinical aspects and medical management Rheum Dis Clin North Am 2009 35 21 44 Keat A Thomas B Hughes R Taylor-Robinson D Chlamydia trachomatis in reactive arthritis Rheumatol Int 1989 9 197 200 Villareal C Whittum-Hudson JA Hudson AP Persistent Chlamydiae and chronic arthritis Arthritis Res 2002 4 5 9 Braun J Laitko S Treharne J Chlamydia pneumoniae--a new causative agent of reactive arthritis and undifferentiated oligoarthritis Ann Rheum Dis 1994 53 100 105 Klinkhoff A Rheumatology: 5. Diagnosis and management of inflammatory polyarthritis CMAJ 2000 162 1833 1838 Kwiatkowska B Filipowicz-Sosnowska A Reactive arthritis Pol Arch Med Wewn 2009 119 60 65 Zochling J Smith EU Seronegative spondyloarthritis Best Pract Res Clin Rheumatol 2010 24 747 756 Contini C Grilli A Badia L Guardigni V Govoni M Seraceni S Detection of Chlamydophila pneumoniae in patients with arthritis: significance and diagnostic value Rheumatol Int 2011 31 1307 1313 Carter JD Gérard HC Whittum-Hudson JA Hudson AP Combination antibiotics for the treatment of Chlamydia-induced reactive arthritis: is a cure in sight? Int J Clin Rheumtol 2011 6 333 345

(A) Radiograph shows no specific bony abnormality. (B, C) Magnetic resonance imaging show subchondral bone marrow edema with synovial thickening of 2nd and 3rd metacarpophalangeal joint and proximal interphalangeal joint.