Clinical features

Articular: Large joints are usually affected:

• mono- or poly- arthritis: typically affecting the knees, ankles, feet & hands
• sacroiliitis: commonly asymptomatic
• plantar fascitis and tenosynovitis
• heel pain due to calcaneal spur enthesopathy

Urethral:

• venereal non-gonococcal urethritis; not seen in the absence of sexual intercourse

Ocular:

• conjunctivitis: usually bilateral, sterile affecting the lower outer tarsal conjunctivae
• less commonly: episcleritis, iritis - after 1 to 12 months - keratitis, often with corneal ulceration

Dermatologic:

• keratoderma blenorrhagica, circinate balinitis, macules, pustules, nail dystrophy, scales

Systemic:

• fever, malaise, cachexia

Rarely there may be pleurisy or pericarditis.