Peripheral arthritis in the course of inflammatory bowel diseases

Dig Dis Sci. 2011 Jan;56(1):183-7. doi: 10.1007/s10620-010-1260-z. Epub 2010 May 11.


Background: Musculoskeletal disorders are well-defined extra-intestinal manifestations of inflammatory bowel diseases (IBD). There is little data regarding the frequencies of IBD and extra-intestinal manifestations from Central and East Europe and Middle Eastern countries.

Aims: To determine the prevalence of peripheral arthritis in IBD and to document the relationship to other extra-intestinal manifestations.

Methods: Enrolled in the study were 357 patients who were diagnosed with IBD from December 2002 through January 2008. All of the patients underwent a detailed whole-body examination by a gastroenterologist and rheumatologist.

Results: IBD-related peripheral arthritis (IBDPA) was found in 66 (18.5%) of the 357 patients (28.3% Crohn's disease, 13.5% ulcerative colitis; p=0.001 χ=11.62). IBDPA was more frequent in female patients (60.6 vs. 39.4%, p=0.000, χ=11.12). In eight (12.1%) cases, IBDPA occurred before the onset of IBD. Acute self-limiting episodes, recurrences of the attacks, and persistent symptoms of arthritis were present in 40 (60.6%), 26 (39.3%), and 29 (45.7%) patients, respectively. Arthritis was symmetrical in 33 (50%) cases. Knees (65.2%) and ankles (62.1%) were the most commonly affected joints. Erythema nodosum and pyoderma gangrenosum were more common among patients with IBDPA than patients without it (p=0.001, χ=10.49, and p=0.000 χ=25.77, respectively).

Conclusions: IBDPA is a frequent extra-intestinal complication of IBD. Those of female gender and the presence of Crohn's disease, erythema nodosum and pyoderma gangrenosum have a higher risk to develop IBDPA.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Ankle Joint*
  • Arthritis / epidemiology*
  • Child
  • Colitis, Ulcerative / complications*
  • Colitis, Ulcerative / epidemiology
  • Crohn Disease / complications*
  • Crohn Disease / epidemiology
  • Erythema Nodosum / complications
  • Erythema Nodosum / epidemiology
  • Europe / epidemiology
  • Female
  • Humans
  • Knee Joint*
  • Male
  • Middle Aged
  • Middle East / epidemiology
  • Prevalence
  • Pyoderma Gangrenosum / complications
  • Pyoderma Gangrenosum / epidemiology
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Young Adult