Rheumatic manifestations in inflammatory bowel disease |
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| Affiliation: | 1. Rheumatology Unit, L. Sacco University Hospital, Milan, Italy;2. Laboratory Unit, Fatebenefratelli Hospital, Milan, Italy;3. Gastroenterology Unit, L. Sacco University Hospital, Milan, Italy;1. The Center for Human Reproduction, New York, NY, United States;2. Department of Medicine, Division of Cardiology, University of Southern California at Los Angeles, Los Angeles, CA, United States;3. Foundation for Reproductive Medicine, New York, NY, United States;1. Rheumatology Department, Reina Sofia University Hospital, Cordoba, Spain;2. Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain;3. University of Cordoba, Cordoba, Spain;4. Rheumatology Department, Cochin Hospital, Paris, France;1. Medicina Gastroenterologica e, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy;2. Reumatologia, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy;3. Dipartimento di Medicina Interna e Gastroenterologia e, Università di Bologna-Policlinico S. Orsola Malpighi, Bologna, Italy;4. Reumatologia, Università di Bologna-Policlinico S. Orsola Malpighi, Bologna, Italy;5. Reumatologia e, Azienda Ospedaliero-Unversitaria di Modena e Università di Modena e Reggio Emilia, Modena, Italy;6. Gastroenterologia, Azienda Ospedaliero-Unversitaria di Modena e Università di Modena e Reggio Emilia, Modena, Italy;7. Reumatologia, Azienda Ospedaliero-Universitaria S. Anna di Ferrara (Cona) e Università di Ferrara, Ferrara, Italy;8. Gastroenterologia, Ospedale Santa Maria della Misericordia, Rovigo, Italy;1. Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Italy;2. Division of Rheumatology, Misericordia e Dolce Hospital, Prato, Italy;3. Gastroenterology Unit, University Federico II, Naples, Italy;4. IBD Unit, Complesso Integrato Columbus, Catholic University, Rome, Italy;5. IBD Unit, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Italy;6. IBD Unit, Internal Medicine, A.O. Ospedali Riuniti “Villa Sofia-Cervello”, Palermo, Italy;7. Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy;8. Rheumatology Unit, Department of Clinical and Experimental Medicine, University Federico II, Naples, Italy;9. Gastroenterology and Gastrointestinal Endoscopy Unit, IRCCS Policlinico San Donato, Department of Biomedical Sciences for the Health, University of Milan, Milan, Italy |
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| Abstract: | Musculoskeletal symptoms (articular, periarticular and muscular involvement, osteoporosis and related fractures, and fibromyalgia) are the most common frequent extra-intestinal manifestations of inflammatory bowel disease (IBD) and affect 6–46% of patients. IBD-related arthropathy is one of a group of inflammatory arthritides known as seronegative spondyloarthropathies (SpA), which also includes idiopathic ankylosing spondylitis (AS), reactive arthritis, psoriatic arthritis, and undifferentiated SpA.The articular involvement in IBD significantly affects the patients’ quality of the life. Although magnetic resonance imaging (MRI) is still the gold standard for assessing entheseal involvement, ultrasonography (US) is a non-invasive and easily reproducible means of detecting early pathological changes in SpA patients. It can identify characteristic features of SpA such as enthesitis, bone erosions, synovitis, bursitis, and tenosynovitis and is therefore helpful for diagnostic purposes.Anti-TNF drugs should be used to treat AS patients with axial and peripheral symptoms (arthritis and enthesitis) who have persistently high levels of disease activity despite conventional treatment, and adalimumab and infliximab can also be beneficially used in patients with IBD. |
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