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[Joint disease in inflammatory bowel disease]
J M Paredes1, M M Barrachina, J Román
1Servicio de Medicina Digestiva, Hospital Universitario Dr. Peset, Universidad de Valencia, Valencia, Spain. chemapar@hotmail.com
Gastroenterologia Y Hepatologia
|April 7, 2005
Summary
Enteropathic arthropathy, a common complication of inflammatory bowel disease (IBD), involves peripheral and axial joint issues. Treatment focuses on managing IBD and associated arthritis with medications like NSAIDs, corticosteroids, or biologics.
Area of Science:
- Rheumatology
- Gastroenterology
- Immunology
Context:
- Enteropathic arthropathy is the most frequent extra-intestinal manifestation of inflammatory bowel disease (IBD).
- It affects approximately 33% of IBD patients, with a prevalence similar to ulcerative colitis and Crohn's disease.
- This condition encompasses peripheral and axial arthritis, alongside other peri-articular disorders.
Purpose:
- To describe the clinical characteristics and treatment of enteropathic arthropathy.
- To differentiate between Type 1 (pauciarticular) and Type 2 (polyarticular) peripheral arthritis in relation to IBD activity.
- To outline management strategies for axial involvement, including ankylosing spondylitis and sacroiliitis.
Summary:
- Enteropathic arthropathy presents as peripheral arthritis (Type 1 coinciding with IBD flares, Type 2 independent) and axial arthritis (independent of IBD, resembling ankylosing spondylitis or sacroiliitis).
- Treatment involves general measures, nonsteroidal anti-inflammatory agents, and potentially intraarticular corticosteroids.
- For refractory cases, sulphasalazine and/or infliximab can address both joint and intestinal manifestations simultaneously.
Impact:
- Provides a comprehensive overview of enteropathic arthropathy for clinicians and researchers.
- Highlights the distinct clinical courses of different arthritis types in IBD patients.
- Informs treatment decisions for managing complex rheumatologic manifestations in IBD.