Study of musculoskeletal manifestations in patients with inflammatory bowel diseases

Abstract

ObjectiveThe aim was to study the involvement of sacroiliac joints, lower limb joints, and enthesis and to detect osteoporosis in patients with inflammatory bowel disease (IBD), and then to correlate them with disease activity in patients with ulcerative colitis (UC).BackgroundIBDs are systemic diseases that commonly display extraintestinal manifestations. Musculoskeletal involvement is one of the most common extraintestinal manifestations.Patients and methodsThis cross-sectional study included 50 patients with IBD who were evaluated for rheumatologic manifestations by clinical examination, laboratory, and radiologic studies such as musculoskeletal ultrasonography of lower limb entheses, digital radiographs of both sacroiliac and hip joints, and dual-energy X-ray absorptiometry scan for evaluation of osteoporosis.ResultsIn this study, we found that most patients had tenderness rather than swelling of joints (knee tenderness in 66% and swelling in 34%). Bilateral sacroiliitis was present in 78% of patients. The proximal patellar entheses were the most inflamed site followed by Achilles tendon entheses. UC disease activity was significantly related to knee, ankle, and entheseal swelling and sacroiliac tenderness. There was a highly significant positive correlation between UC disease activity and fecal calprotectin level and a nonsignificant negative correlation with dual-energy X-ray absorptiometry scan T-score.ConclusionMusculoskeletal manifestations are common in patients with IBD and should be studied clinically and radiologically by expert rheumatologist for early detection and management.