title: Classifying Back Pain and Peripheral Joint Complaints in Inflammatory Bowel Disease Patients: A Prospective Longitudinal Follow-up Study.
abstract: OBJECTIVE
  Peripheral joint complaints [pJTC] and chronic back pain [CBP] are the most common extra-intestinal manifestations in patients with inflammatory bowel disease [IBD]. This prospective study evaluates variables associated with joint/back pain, including IBD disease activity.
  
  
  METHODS
  IBD patients with back pain ≥ 3 months and/or peripheral joint pain/swelling [n = 155], and IBD patients without joint complaints [n = 100; controls], were followed for a period of 1 year. Patients were classified as having SpondyloArthritis [SpA] according to several sets of criteria. Statistical analysis included logistic regression models and linear mixed model analysis.
  
  
  RESULTS
  Of the 155 patients with joint/back pain, 13 had chronic back pain, 80 peripheral joint complaints, and 62 axial and peripheral joint complaints. Smoking, female gender, and IBD disease activity were independently associated with IBD joint/back pain. The Assessment in Spondyloarthritis International Society criteria for axial and peripheral SpA were fulfilled in 12.3% of patients, with 9.7% [n = 15] receiving a rheumatological diagnosis of arthritis. During the 12-month follow-up, the majority of the patients reporting joint/back pain remained stable.
  
  
  CONCLUSIONS
  In our cohort, the majority of IBD patients reported joint/back pain and SpA was relatively common. To facilitate effective care, gastroenterologists should be aware of the various features of SpA to classify joint complaints and, by making use of an efficient referral algorithm, to refer CBP patients to the rheumatologist.
authors.affiliation: Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: S J
authors.initials: SJ
authors.lastname: van Erp
authors.affiliation: Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: L K
authors.initials: LK
authors.lastname: Brakenhoff
authors.affiliation: Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: F A
authors.initials: FA
authors.lastname: van Gaalen
authors.affiliation: Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: van den Berg
authors.affiliation: Department of Gastroenterology and Hepatology , University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: H H
authors.initials: HH
authors.lastname: Fidder
authors.affiliation: Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: H W
authors.initials: HW
authors.lastname: Verspaget
authors.affiliation: Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: T W
authors.initials: TW
authors.lastname: Huizinga
authors.affiliation: Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: R A
authors.initials: RA
authors.lastname: Veenendaal
authors.affiliation: Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Wolterbeek
authors.affiliation: Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: D
authors.initials: D
authors.lastname: van der Heijde
authors.affiliation: Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands ae.meulen@lumc.nl.
authors.forename: A E
authors.initials: AE
authors.lastname: van der Meulen-de Jong
authors.affiliation: Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands Center for Inflammatory Bowel Diseases, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: D W
authors.initials: DW
authors.lastname: Hommes
mesh_terms: D000328:Adult; D001416:Back Pain / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D002097:C-Reactive Protein / Q000378:metabolism*; D059350:Chronic Pain; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D007592:Joint Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D010147:Pain Measurement / Q000379:methods*; D011446:Prospective Studies; D057566:Self Report; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D002097:C-Reactive Protein
keywords: Crohn’s disease; Inflammatory bowel disease; arthropathy; spondyloarthritis; ulcerative colitis