MBBS OSCE · General Medicine
OSCE — Reactive Arthritis (Reiter Syndrome)
Eight-minute OSCE station on Reactive Arthritis (Reiter Syndrome): focused history, examination priorities, investigations, emergency and definitive management.
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Exam tags
Brief (to candidate)
You will assess a patient with a presentation consistent with Reactive Arthritis (Reiter Syndrome).
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Reactive arthritis (ReA, formerly Reiter syndrome) is a sterile inflammatory arthritis arising 1 to 4 weeks after an extra-articular infection (classically genitourinary — Chlamydia trachomatis; or gastrointestinal — Campylobacter, Salmonella, Shigella, Yersinia, Clostridioides difficile), belonging to the HLA-B27-associated seronegative spondyloarthropathies. The classic triad (Reiter): arthritis (asymmetric, lower-limb oligoarthritis), urethritis/cervicitis, and conjunctivitis/uveitis ('can't see, can't pee, can't climb a tree'). Characteristic features include enthesitis, dactylitis (sausage digit), sacroiliitis, keratoderma blennorrhagicum, circinate balanitis, painless oral ulcers, and
Candidate tasks
- Clarify onset, severity, associated features, and red-flag symptoms.
- State focused examination priorities.
- List first-line investigations and any named score/criteria.
- Give immediate resuscitation steps.
- Outline definitive management with doses/routes where standard.
- Name complications and disposition (ward / HDU / theatre / discharge safety-net).
- Mention one special-population modifier (pregnancy, child, elderly, CKD).
Examiner checklist
| Domain | Pass behaviours |
|---|---|
| Definition | Correct working diagnosis language |
| Assessment | Focused, prioritised, red flags sought |
| Investigations | Appropriate first-line + interpretation |
| Emergency care | ABC / time-critical actions first |
| Definitive care | Specific drugs/procedures, not generic phrases |
| Safety | Asymmetric lower-limb oligoarthritis 1 to 4 weeks after diarrhoea or a sexually |
| Safety | Arthritis plus conjunctivitis and urethritis (can't see, can't pee, can't climb |
| Safety | Dactylitis (sausage digit) with enthesitis and preceding infection - reactive/sp |
| Communication | Clear plan and safety-netting |
Model outline
Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.