Diffuse mucosal granularity in double-contrast studies of Crohn's disease of the colon

The radiographic manifestations of idiopathic ulcerative colitis and Crohn's disease of the colon have been extensively reviewed and are well known. The increasing use of primary double-contrast barium enemas in patients with inflammatory bowel disease has led to enthusiastic reports concerning the differentiation of ulcerative colitis and Crohn's disease. Typically, in ulcerative colitis there is a continuous, diffuse granular mucosal pattern, with or without superadded ulceration; in contrast, Crohn's colitis is characterised by discrete ulcers with intervening normal mucosa. In this paper the occurrence of continuous diffuse mucosal granularity in Crohn's disease of the colon is described. Four selected cases are used as illustrative examples to emphasise the non-specific nature of this particular finding. Caution must be exercised in attributing specific mucosal patterns to the various forms of infectious and non-infectious colitis.