title: 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.affiliation: Rheumatology Unit, L. Sacco University Hospital, Milan, Italy.
authors.forename: Fabiola
authors.initials: F
authors.lastname: Atzeni
authors.forename: Caterina
authors.initials: C
authors.lastname: Defendenti
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Ditto
authors.forename: Alberto
authors.initials: A
authors.lastname: Batticciotto
authors.forename: Donatella
authors.initials: D
authors.lastname: Ventura
authors.forename: Marco
authors.initials: M
authors.lastname: Antivalle
authors.forename: Sandro
authors.initials: S
authors.lastname: Ardizzone
authors.forename: Piercarlo
authors.initials: P
authors.lastname: Sarzi-Puttini
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000209:etiology / Q000276:immunology*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000188:drug therapy / Q000276:immunology*; D025242:Spondylarthropathies; D013585:Synovitis / Q000276:immunology
chemical_list: D000893:Anti-Inflammatory Agents
keywords: Articular manifestations; Enthesitis; Inflammatory bowel disease; Ultrasonography