What is the recommended action for joint aspiration in reactive arthritis?

Joint aspiration in reactive arthritis serves multiple purposes, including diagnostic and therapeutic roles. One of the primary reasons for performing a joint aspiration is to rule out septic arthritis, which is a potentially serious condition that requires immediate treatment. In reactive arthritis, the presence of joint effusion can resemble that of septic arthritis, which is characterized by an infection within the joint space.

By performing an aspiration, the clinician can analyze the synovial fluid to check for signs of infection, such as elevated white blood cell counts, the presence of bacteria in cultures, and other markers that would indicate septic arthritis rather than reactive arthritis. This distinction is critical because the management of septic arthritis, which may involve antibiotics and further interventions, is different from that of reactive arthritis.

While relieving pain and reducing inflammation is a benefit of aspiration, and it does allow for the drainage of excess synovial fluid, these objectives are secondary to the crucial diagnostic aspect of ruling out an infectious cause. Thus, the primary reason to perform joint aspiration in this context is to ensure that a serious condition like septic arthritis is not present.