Yersinia arthritis, a form of reactive arthritis, is an inflammatory joint condition that develops in response to an infection by the bacterium Yersinia enterocolitica or Yersinia pseudotuberculosis. These bacteria typically cause gastrointestinal infections, and joint inflammation may appear days to weeks later, even after the infection has resolved (1).
Symptoms
Yersinia-induced reactive arthritis can vary in severity. Common signs include:
- Joint pain and swelling, often in the knees, ankles, or feet
- Asymmetrical arthritis, affecting one side of the body more
- Lower back pain
- Enthesitis (pain where tendons attach to bones)
- Conjunctivitis (eye inflammation)
- Fatigue and general discomfort
Symptoms usually appear 1-3 weeks after the gastrointestinal infection and may last for several weeks or months (1).
Causes and Risk Factors
Yersinia arthritis is caused by a post-infectious autoimmune response to a prior intestinal infection with Yersinia bacteria. The bacteria are usually contracted through:
- Contaminated food or water
- Undercooked pork or unpasteurized milk
- Poor sanitation or hygiene practices
Risk factors include:
- HLA-B27 gene positivity (a genetic marker associated with reactive arthritis)
- Age between 20–40 years
- Recent history of gastroenteritis
- Weakened immune system (1)(2)
Complications
If not treated early, Yersinia arthritis may lead to:
- Chronic joint pain
- Recurrent flare-ups
- Uveitis (eye inflammation)
- Sacroiliitis (inflammation of the sacroiliac joints)
In some cases, joint damage can persist even after inflammation resolves (2).
Diagnosis
Doctors use several methods to diagnose Yersinia arthritis:
- A detailed medical history, especially noting recent stomach or intestinal illness
- Physical examination for swelling, redness, and movement restriction
- Blood tests for inflammation and HLA-B27
- Stool culture (if the infection is recent)
- Joint fluid analysis to rule out other causes, such as infection or crystal arthritis (2)(3)
Treatment
Treatment focuses on relieving symptoms and managing inflammation. Common approaches include:
- NSAIDs like ibuprofen or naproxen for pain
- Antibiotics, if the infection is still active (not useful once arthritis has developed)
- Corticosteroids (oral or injected) for severe inflammation
- DMARDs like sulfasalazine for persistent or chronic symptoms
- Physical therapy to improve flexibility and strength
- Adequate rest and lifestyle modifications during flare-ups
Most patients recover within a few months, although some may require long-term care (3).
Prevention
Yersinia arthritis is a potentially painful but usually temporary condition that follows a bacterial gastrointestinal infection. Early diagnosis and appropriate treatment can reduce symptoms and prevent long-term joint problems (3).
References
1. Honda K, Iwanaga N, Izumi Y, Tsuji Y, Kawahara C, Michitsuji T, Higashi S, Kawakami A, Migita K. Reactive Arthritis Caused by Yersinia enterocolitica Enteritis. Intern Med. 2017;56(10):1239-1242. doi: 10.2169/internalmedicine.56.7888. Epub 2017 May 15. PMID: 28502944; PMCID: PMC5491824.
2. Toivanen, A., Granfors, K., Lahesmaa-Rantala, R., Leino, R., Ståhlberg, T., & Vuento, R. (1985). Pathogenesis of Yersinia-triggered reactive arthritis: immunological, microbiological and clinical aspects. Immunological reviews, 86, 47-70.
3. Hannover Larsen, J. (1980). Yersinia enterocolitica infections and rheumatic diseases. Scandinavian Journal of Rheumatology, 9(3), 129-137.
