Musculoskeletal manifestations in inflammatory bowel disease

Area of Science:

• Rheumatology
• Gastroenterology
• Immunology

Background:

• Musculoskeletal manifestations are the most frequent extra-intestinal complication of inflammatory bowel disease (IBD).
• These manifestations are part of the spondylarthropathy spectrum, including axial and peripheral arthritis, dactylitis, and enthesopathy.
• Their prevalence varies based on diagnostic criteria and patient selection.

Purpose of the Study:

• To discuss the epidemiological, clinical, and diagnostic aspects of musculoskeletal manifestations in IBD.
• To review the role of intestinal bacteria and immunogenetic factors in the pathogenesis of IBD-associated arthritis.
• To summarize current therapeutic options for these conditions.

Main Methods:

• Observational study of an inception cohort of newly diagnosed IBD patients.
• Review of epidemiological, clinical, and diagnostic features.
• Brief review of pathogenetic factors and therapeutic strategies.

Main Results:

• Musculoskeletal manifestations were observed in 30.7% of newly diagnosed IBD patients.
• Peripheral findings like seronegative oligoarthritis, dactylitis, and enthesopathy are common.
• These symptoms can sometimes be the sole presenting feature of IBD.

Conclusions:

• Clinicians must carefully assess rheumatological findings in IBD patients for timely diagnosis and management.
• Understanding the pathogenesis involving gut microbiota and immune factors is crucial.
• Appropriate therapeutic strategies are essential for managing IBD-associated musculoskeletal complications.