Inflammatory bowel disease related arthritis
An enteropathic arthritis, sacroiliitis, ankylosing spondylitis or rarely hypertrophic osteoarthritis in association with ulcerative colitis or Crohnâ€™s disease.
10% of ulcerative colitis patients and 15â€“20% of Crohnâ€™s patients.
Commonest at 20â€“45 years.
The aetiology is unknown but the synovitis may occur in response to bacterial antigens that have passed through the damaged gut wall. Enteropathic arthritis is a seronegative non-erosive synovitis. Sacroiliitis is related to the presence of HLA B27
An acute, self-limiting, asymmetrical non-deforming arthritis usually affecting knees or ankles. Treatment of the inflammatory bowel disease leads to resolution of arthritis.
Inflammatory bowel disease is treated as normal. Use of nonsteroidal anti-inflammatory drugs for treatment of joint pain may make diarrhoea worse. Intra-articular steroid injections may be of value.