Rheumatic manifestations in inflammatory bowel disease.

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.

• Authors: Fabiola Atzeni, Caterina Defendenti, Maria Chiara Ditto, Alberto Batticciotto, Donatella Ventura, Marco Antivalle, Sandro Ardizzone, Piercarlo Sarzi-Puttini
• Journal: Autoimmunity reviews (Autoimmun Rev) Vol. 13 Issue 1 Pg. 20-3 (Jan 2014) ISSN: 1873-0183 [Electronic] Netherlands
• PMID: 23774109 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2013 Elsevier B.V. All rights reserved.

Chemical References

• Anti-Inflammatory Agents

Topics

• Anti-Inflammatory Agents (therapeutic use)
• Arthritis, Rheumatoid (drug therapy, etiology, immunology)
• Humans
• Inflammatory Bowel Diseases (complications, drug therapy, immunology)
• Spondylarthropathies
• Synovitis (immunology)