individual

Information for Doctors

Sports-Medicine Kalyan-Dombivali
Other types of Arthritis
Arthritis associated with inflammatory bowel disease (IBD)
Peripheral arthritis
  Ankylosing Spondylitis Type:
  Asymptomatic Sacroilitis:
  Associated rheumatic conditions:
  Associated bony lesions:
  Treatment Protocol 
  Role of treatment modalities in peripheral arthritis versus axial skeleton involvement
Intestinal Bypass Arthritis:
  Etiopathogenesis
  Clinical types:
  Joints involved
  Sex prevalence
  Associated findings
  Lab findings
  Treatment
Arthritis associated with inflammatory bowel disease (IBD)

Bowel diseases associated with inflammatory arthritis:

  1. Idiopathic inflammatory bowel disease (ulcerative colitis, crohn's disease) and pouchitis
  2. Microscopic colitis and collagenous colitis
  3. Whipple's disease
  4. Gluten -sensitive enteropathy (celiac disease)
  5. Infectitious gastroenteritis
  6. Intestinal bypass arthritis
Classification:
Refer to chart : Click here
Arthritis is more likely in patients with large bowel disease and in those with complications such as abscesses, perianal disease, massive haemorrhage, erythema nodosum, oral ulcerations and uveitis.
Peripheral arthritis:
It is usually mild oligoarticular arthritis more common with exacerbations of IBD involving knee, ankle and wrist joints. Arthritic changes are mild and there may be multiple episodes of remissions and exacerbations but overall prognosis is good.

Ankylosing Spondylitis Type:

The features are similar to AS with high incidence of HLA B27. Spondylitis may proceed IBD with their clinical courses unrelated. It has a slowly progressive course.

Asymptomatic Sacroilitis:

There is no increase frequency of HLA B27 in these patient. It may not progress to spondylitis.

Associated rheumatic conditions:

  1. Achilles tendinitis / planter fasciitis
  2. Clubbing
  3. Hypertrophic osteoarthropathy
  4. Psoas abscess or septic hip from fistula (crohn's disease)
  5. Vasculitis
  6. Amyloidosis

Associated bony lesions:

Osteoporosis: It may occur due to inactivity, malabsorption or treatment with steroids.

Osteomalacia: It may result from malabsorption.

Treatment Protocol :
Refer to Chart : Click here
Role of treatment modalities in peripheral arthritis versus axial skeleton involvement:
Refer to table : Click here

Intestinal Bypass Arthritis:

In about one fourth of patients with intestinal bypass, arthritis may develop as postoperative complication weeks or even years after surgery.

Etiopathogenesis:
Refer to Chart : Click here

Clinical types:

  1. Polyarthralgia
  2. Arthritis
  3. Tenosynovitis

Joints involved:

Knee, wrist, ankle, shoulder and finger joints

Sex Prevalence:

More females are affected than males

Associated findings:

  1. Urticarial, vasicular, pustular, macular or nodular eruption
  2. Raynaud's symptoms

Lab Findings:

Tests for RA factors, ANA and HLAB27 is negative.

Treatment:
Refer to chart : Click here