title: Prevalence of self-reported spondyloarthritis features in a cohort of patients with inflammatory bowel disease.
abstract: BACKGROUND
  Musculoskeletal symptoms belonging to the spectrum of 'seronegative spondyloarthritis' (SpA) are the most common extraintestinal manifestations in patients with inflammatory bowel disease (IBD) and may lead to important disease burden. Patients with suspected SpA should be referred to a rheumatologist for further evaluation.
  
  
  OBJECTIVE
  To investigate the self-reported prevalence of musculoskeletal SpA features in a cohort of patients with IBD and to compare this with actual referrals to a rheumatologist.
  
  
  METHODS
  Consecutive patients with IBD visiting the outpatient clinic were interviewed by a trained research nurse about possible SpA features using a standardized questionnaire regarding the presence or history of inflammatory back pain, peripheral arthritis, enthesitis, dactylitis, psoriasis, uveitis and response to nonsteroidal anti-inflammatory drugs. All patient files were verified for previous visits to a rheumatologist and any rheumatic diagnosis.
  
  
  RESULTS
  At least one musculoskeletal SpA feature was reported by 129 of 350 (36.9%) patients. No significant differences between patients with Crohn disease and ulcerative colitis were found. Review of medical records showed that 66 (51.2%) patients had ever visited a rheumatologist. Axial SpA was diagnosed in 18 (27.3%) patients, peripheral SpA in 20 (30.3%) patients and another rheumatic disorder in 14 (21.2%) patients.
  
  
  CONCLUSIONS
  Musculoskeletal SpA features are frequently present in patients with IBD. However, a substantial group of patients is not evaluated by a rheumatologist. Gastroenterologists play a key role in early referral of this often debilitating disease.
authors.affiliation: Department of Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands. c.stolwijk@maastrichtuniversity.nl
authors.forename: Carmen
authors.initials: C
authors.lastname: Stolwijk
authors.forename: Marieke
authors.initials: M
authors.lastname: Pierik
authors.forename: Robert
authors.initials: R
authors.lastname: Landewé
authors.forename: Ad
authors.initials: A
authors.lastname: Masclee
authors.forename: Astrid
authors.initials: A
authors.lastname: van Tubergen
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000453:epidemiology; D003424:Crohn Disease / Q000453:epidemiology; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012219:Rheumatology / Q000706:statistics & numerical data; D057566:Self Report; D025241:Spondylarthritis / Q000453:epidemiology*; D025242:Spondylarthropathies / Q000453:epidemiology; D013167:Spondylitis, Ankylosing / Q000453:epidemiology; D011795:Surveys and Questionnaires