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Rheumatic manifestations in inflammatory bowel disease
Fabiola Atzeni1, Caterina Defendenti, Maria Chiara Ditto
1Rheumatology Unit, L. Sacco University Hospital, Milan, Italy.
Autoimmunity Reviews
|June 19, 2013
Summary
Musculoskeletal symptoms are common in inflammatory bowel disease (IBD). Ultrasonography (US) effectively detects early joint and entheseal changes in IBD-associated spondyloarthropathies (SpA), aiding diagnosis and treatment decisions.
Area of Science:
- Rheumatology and Gastroenterology
- Diagnostic Imaging in Inflammatory Diseases
Background:
- Musculoskeletal symptoms, including articular, periarticular, and muscular involvement, are frequent extra-intestinal manifestations of inflammatory bowel disease (IBD), affecting 6-46% of patients.
- IBD-related arthropathy is classified within seronegative spondyloarthropathies (SpA), encompassing conditions like ankylosing spondylitis (AS), reactive arthritis, and psoriatic arthritis.
- Articular involvement in IBD significantly impairs patients' quality of life.
Purpose of the Study:
- To highlight the prevalence and impact of musculoskeletal symptoms in IBD patients.
- To evaluate the utility of ultrasonography (US) in diagnosing SpA features in IBD.
- To discuss therapeutic implications, including anti-TNF agents for AS and IBD.
Main Methods:
- Review of current literature on IBD-related musculoskeletal manifestations.
- Comparison of diagnostic capabilities of magnetic resonance imaging (MRI) and ultrasonography (US) for entheseal involvement.
- Analysis of treatment guidelines for SpA in the context of IBD.
Main Results:
- Ultrasonography (US) is a non-invasive, reproducible method for detecting early pathological changes in SpA.
- US can identify characteristic SpA features such as enthesitis, bone erosions, synovitis, bursitis, and tenosynovitis.
- Anti-TNF therapies (adalimumab, infliximab) are beneficial for treating axial and peripheral symptoms in AS and IBD patients with active disease.
Conclusions:
- Ultrasonography (US) is a valuable tool for the early diagnosis and monitoring of SpA in patients with IBD.
- Effective management of IBD-associated musculoskeletal symptoms can improve patients' quality of life.
- Anti-TNF agents represent an important therapeutic option for refractory SpA and IBD-related arthritis and enthesitis.
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