RHEUMATOLOGY

IBD-associated spondyloarthropathy

  • Associated with Inflammatory Bowel Disease
  • Greater association with Crohn’s Disease
  • No synovial destruction
  • Course
    • Does not resolve after proctocolectomy
    • Often subsides in 6-8 weeks after onset
    • Often recurrs and may become chronic in 10% of cases
  • Symptoms
    • Asymmetric joint involvement
    • Migratory Arthritis or Monoarticular Arthritis
    • Lower extremity more often involved
      • Joints affected
      • Hip
      • Ankle
  • Low Back Pain with morning stiffness
  • Associated Spine conditions
    • Ankylosing Spondylitis
    • Sacroiliitis
    • Axial Arthritis
    • Extra-articular changes
    • Bilateral Uveitis
    • Skin changes
    • Erythema Nodosum
    • Pyroderma gangrenosum
  • Management
    • Avoid NSAIDs if possible
    • Sulfasalazine
    • Methotrexate
    • Azathioprine
    • Etanercept (TNF-a inhibitor)

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