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Spondyloarthropathy due to Inflammatory Bowel DiseaseAka: Crohn's Disease Associated Arthritis, Ulcerative Colitis Associated Arthritis, Colitic Arthritis, Arthritis associated with Ulcerative Colitis, Inflammatory Bowel Disease with Spondyloarthropathy, Arthropathy of Inflammatory Bowel Disease, Enteropathic Arthritis

See Also
1. Inflammatory Bowel Disease
Pathophysiology
1. Associated with Inflammatory Bowel Disease
2. Greater association with Crohn's Disease
3. No synovial destruction
Symptoms
1. Asymmetric joint involvement
  1. Migratory arthritis or Monoarticular Arthritis
  2. Lower extremity more often involved
2. Joints affected
  1. Hip
  2. Ankle
  3. Wrist
  4. Elbow
3. Low Back Pain with morning stiffness
4. Associated Spine conditions
  1. Ankylosing Spondylitis
  2. Sacroiliitis
  3. Axial arthritis
5. Extra-articular changes
  1. Bilateral Uveitis
  2. Skin changes
    1. Erythema Nodosum
    2. Pyroderma gangrenosum
Management
1. Avoid NSAIDs if possible
2. Sulfasalazine
3. Methotrexate
4. Azathioprine
5. Etanercept (TNF-a inhibitor)
Course
1. Does not resolve after proctocolectomy
2. Often subsides in 6-8 weeks after onset
3. Often recurrs and may become chronic in 10% of cases
References
1. Liu in Noble (2001) Primary Care, p. 86-7
2. Holden (2003) Rheum Dis Clin North Am 29(3):513

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 5/10/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.