Articular manifestations in inflammatory bowel disease patients: a prospective study

Dig Liver Dis. 2009 Aug;41(8):565-9. doi: 10.1016/j.dld.2009.01.013. Epub 2009 Mar 10.


Background and aims: Rheumatic manifestations are frequent in inflammatory bowel disease (IBD) and are associated with a wide range of clinical patterns.

Methods: Articular symptoms and signs were investigated by questionnaire in a cohort of 651 pts, mean age 42+/-14 years, followed at two referral hospitals over a 12-month period.

Results: 142 ulcerative colitis (UC) and 120 Crohn's disease (CD) patients referred articular pain during their IBD history: in 46% this was associated with active IBD, in 56% symptoms were intermittent and in 19% symptoms preceded IBD diagnosis. 62 pts (28 UC, 34 CD) complaining of articular symptoms at the time of the interview, were investigated by the rheumatologist: arthropathy was axial in 52%, oligoarticular in 16% and polyarticular in 23%. Oligoarthritis commonly involved the lower limbs and was more commonly associated with UC. The mean number of small joints involved was significantly higher in CD than in UC pts (9.9+/-8.2 vs. 5.6+/-4.3; p<0.01). Bone scintigraphy was abnormal in 70% of pts.

Conclusions: Prevalence of self-reported articular symptoms in IBD patients exceeds 40% with 9.5% incidence during 1-year follow up. Symptoms predict entheropatic involvement of the locomotor system.

MeSH terms

  • Adult
  • Arthralgia / complications
  • Arthritis / complications*
  • Arthritis / diagnostic imaging
  • Colitis, Ulcerative / complications*
  • Colitis, Ulcerative / drug therapy
  • Colitis, Ulcerative / pathology
  • Crohn Disease / complications*
  • Crohn Disease / drug therapy
  • Crohn Disease / pathology
  • Female
  • HLA-B27 Antigen / blood
  • Humans
  • Intestines / pathology
  • Male
  • Radionuclide Imaging
  • Spondylitis, Ankylosing / complications
  • Spondylitis, Ankylosing / diagnostic imaging


  • HLA-B27 Antigen