Sexually Acquired Reactive Arthritis (SARA)

What is SARA?

Sexually acquired reactive arthritis ( SARA) is a reactive arthritis caused by an immune reaction to an infection, often a sexually transmitted infection. It is caused by immune complexes ( so antibodies that fight infection and proteins from the infection) being deposited in the joints .

It is caused by sexual infections ( chlamydia or mycoplasma) , bowel infections ( campylobacter and salmonella) and some bacteria that can cause chest infections.

It is most commonly seen in young adults and men are affected more than women.

Those who have a specific gene HLA B27 are most commonly affected .

A rare complication of STIs

Joint pain, swelling and stiffness

Requires specialist input and physio

Can recur with re-infection; be careful!

What are the symptoms?

The arthritis causes pain, stiffness and swelling in the affected joints.

The knees ankles and feet are most commonly affected.

There are often other symptoms as well, such as the pain passing urine (seen in men most commonly), conjunctivitis ( eye inflammation) together with the original infection symptom. Howver the original infection may have been treated and symptoms resolved before the arthritis starts.

How is it diagnosed?

Sexual infection tests, urine and blood tests may be taken.

A history will be taken to ask about your medical history.

What is the treatment?

Treating the underlying infection is very important- this is usually with a course of antibiotics

Anti inflammatory medication (such a ibuprofen or naproxen) is given as well to reduce any irritation in the joints)

Physiotherapy is very important to preserve movement in the affected joints.

In severe cases, other medications and treatments may be needed.

Useful information

To find out more visit the NHS website.