Can we differentiate between acute rheumatic fever and post-streptococcal reactive arthritis?

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Acute rheumatic fever has some clinical overlap with post-streptococcal reactive arthritis. In fact, some have considered post-streptococcal arthritis to be part of the spectrum of acute rheumatic fever. Barash et al retrospectively evaluated 68 patients with acute rheumatic fever and 159 patients with post-streptococcal reactive arthritis. They found significant differences in erythrocyte sedimentation rate, C-reactive protein, duration of joint symptoms after starting anti-inflammatory treatment, and relapse of joint symptoms after cessation of treatment. Thus, it appears that the two are separate entities that can be distinguished with clinical and laboratory variables.