Symptoms of reactive arthritis may begin 2 to 6 weeks following infection and can last from 3 to 12 months and vary in severity. The first to appear are usually urinary symptoms, followed by fever, eye symptoms, and then arthritis; however, not all cases will follow this order or have all types of symptoms.
1. Urethritis – inflammation of the tube that connects the bladder to the outside of the body (urethra); this causes discharge that will be seen at the tip of the penis or in the vaginal area; it also causes pain or burning on urination. Men may also develop inflammation of the prostate gland (prostatitis) and women may have inflammation of the cervix (cervicitis), although urethritis is often absent in women.
2. Conjunctivitis or uveitis – inflammation of the thin membrane that covers the eyeball and lines the eyelids (conjunctiva) or of the inner eye (uveitis); conjunctivitis causes redness and itching; uveitis is more serious and causes pain, blurring of vision, and light sensitivity, as well as redness in the eye.
3. Arthritis – pain, redness and swelling affecting typically the knees, ankles, and feet; often results in heel pain; can cause swollen fingers and toes; often associated with lower back and buttock pain; can cause spondylitis (inflammation of the joints between vertebrae in the spine)
Reactive arthritis can also be associated with skin symptoms, including oral ulcers, rash or bumps on the soles of the feet or palms of the hands, and painless penile lesions.