Genu Varum Deformity Research Articles

Combination of Lipofilling With Liposuction in the Correction of Pseudo Genu Varus Deformity.

The combined use of lipofilling and liposuction has not been reported for the correction of pseudo genu varus deformity. The aim of this study was to evaluate the utility of combined liposuction and lipofilling for a bilateral correction of pseudo genu varus deformity based on a single-center experience over a 13-year period. A total of 72 patients with pseudo genu varus deformity treated with combined liposuction and lipofilling were included. Data on postoperative complications, the need for additional rounds of lipofilling, and aesthetic outcomes over an average of 5 years (range, 1-9 years) were recorded. Fat harvested from the upper medial portion of the knee was sufficient for lipofilling in 12 (16.7%) patients, and additional donor sites were used in 60 (83.3%) patients. A second round of lipofilling (average, 20 mL; range, 15-50 mL) was required in 17 (23.6%) patients within 6 months to 1 year after the operation. The need for additional lipofilling or liposuction was not noted for any other patients. None of the patients developed major complications such as fat necrosis, infections, contour deformities, or medial concavities during knee flexion. The current findings strongly suggest that the combined use of liposuction and lipofilling for the correction of pseudo genu varus deformity is a feasible, effective, and safe alternative that seems to offer additional benefits compared with fat grafting alone, including a fast recovery, a low risk of complications, and an increased likelihood of a long-lasting correction of the calf contour.

Preoperative Clinical Correctability and Prediction of the Prosthesis Type in Total Knee Arthroplasty for ‌Severe Osteoarthritic Varus Deformity

Background: The preoperative identification of patients who might need constrained condylar knee (CCK) prosthesis in total knee arthroplasty (TKA), is essential to ensure the availability of equipment and to address the patients’ expectations accurately. Objectives: In this study, we aimed at investigating if the preoperative features of the patients can provide this data. Methods: A total of 30 patients who underwent primary TKA for severe osteoarthritic genu varum deformity (varus angle ≥20º) were evaluated in this retrospective study. Prosthesis selection was based on preoperative and intraoperative information. Demographic data, preoperative correctability of the deformity, and intraoperative information, including the reduction osteotomy, soft-tissue release, and pie-crust technique, were retrospectively collected. Soft-tissue release was performed in a sequential manner in 3 steps. Results: The study population included 4 males and 26 females with a mean±SD age of 64.6±8.7 years. A CCK prosthesis was used in 11 (36.7%) cases. A significant association was found between the preoperative correctability and the type of prosthesis. In other words, all CCK prostheses were used in patients who were preoperatively non-correctable (P<0.001). Also, the step of release was significantly associated with the type of prosthesis, and CCK prosthesis was used in all patients with step 3 release (P<0.001). Preoperative correctability was significantly related to the step of release, as well. It means that all deformities with step 3 release were preoperatively non-correctable (P=0.008). Conclusion: The preoperative clinical evaluation of correctability could be used in the identification of patients who might need a CCK prosthesis.

Reporting Outcome and Evaluating the Efficacy of Biplanar Lateral Distal Femoral Osteotomy: Two Years Follow up Study

Introduction: Genu valgum could be approached by uniplanar or biplanar osteotomy in which site union and postoperative knee range of motion play important roles in technique selection.
 Methods: Study was performed on 30 cases including 14 males and 16 females. Two of them had severe genu varum deformity and 28 had genu valgum. Participants underwent biplanar lateral distal femoral osteotomy. Osteotomy requirement was assessed by Lateral distal femoral angle measurement.
 Results: Thirty patients underwent the biplanar procedure over the 4 years. Two years follow up showed complete union, full knee range of motion and within the acceptable alignment.
 Conclusion: Biplanar osteotomy is an effective method to create the wider inner cancellous surface to achieve better osteotomy site union and knee range of motion.

Evaluation of posture and flexibility in ballet dancers

Objectives: Ballet dancers require a high level of control on their muscles in order to perform various dance figures. Special ballet moves require adaptive changes in order to maintain posture while performing classical ballet dance. The aim of the present study was to evaluate the differences in body postures and range of motion in certain joints between female classical ballet students and female non-dancer students. Methods: Fifty nine female university students participated in the study; 30 were studying classical ballet at Hacettepe University Ankara State Conservatory and 29 were studying at Baflkent University with no professional dancing history. Students in both groups were compared by conducting a body posture analysis anteriorly, laterally and posteriorly with the symmetrigraf chart. Range of motion of the joints was measured using a goniometer and distances were measured using an anthropometer. Results: Ballet education was a factor in the development of hallux valgus and genu varum deformities (p 0.05). The median values of body flexion and hyperextension showed statistically significant differences between the two groups (p<0.001). Conclusion: Postural defects caused by the adaptive changes that occur during ballet training can be assessed easily by using a symmetrigraph. It is also possible to evaluate the degree of the deformities that can develop by time.

Effect of 16-week corrective training program on three dimensional joint moments of the dominant and non-dominant lower limbs during gait in children with genu varus deformity

Summary Context Proper treatment of lower limbs alignment in children may prevent the progression of pathologies. However, this is not evaluated from a scientific view-point. Objective The purpose of this study was to evaluate the effects of a 16-week Corrective Exercise Continuum (CEC) programming strategy on three dimensional joint moments of dominant and non-dominant lower limbs during walking. Design Randomized control trials. Setting Sports biomechanics laboratory. Participants Twenty eight male children with genu varus and with permission of their parents were volunteered to participate in this study. They were randomly divided in two equal-sized groups (experimental and control). Intervention Corrective Exercise Continuum (CEC) programming strategy. Main Outcome Measures Data acquisition was carried out using six infrared motion analysis cameras (Vicon motion Systems, Oxford, UK) and two force platforms (Kistler AG, Winterthur, Switzerland). The joint moments of the ankle, knee, and hip of the both lower extremities were calculated using inverse dynamics approach. Results The results indicated that CEC decreased the peak knee internal rotation moment (P Conclusions Performing CEC could reduce excessive knee internal rotation moment as well as hip external rotation moment identified as two key risk factors for medial knee osteoarthritis. Therefore, it would be recommended for children with genu varus, in that it can prevent and slow joint degeneration in adulthood.

Outcome of simultaneous high tibial osteotomy and anterior cruciate ligament reconstruction in anterior cruciate ligament deficient varus knee

For patients with concomitant genu varum deformity and anterior cruciate ligament deficiency, there is constant adduction moment at knee joint during weight bearing leading to increased load over medial compartment. In this prospective cohort study we treated these patients by anatomical single bundle ACL reconstruction and medial open wedge high tibial osteotomy and evaluated their clinical and radiological outcomes. The mean follow up period was 25 months. The mean International Knee Documentation Committee score improved from pre-oprerative 45 to post-operative 77. Range of motion was near normal in all cases. Lachman test and Pivot-shift test showed significant improvement post-operatively. The femorotibial mechanical axis was significantly corrected from 7.0° varus to 1.2° valgus and tibial posterior slope was not significantly changed. Thus to conclude although the procedure requires long learning curve, it decreases load on medial compartment, preserving articular cartilage and reduces adduction moment thereby lessening tension on the graft, both of which are important for future of these knees.

Acute correction of adolescent tibia vara with biplanar medial opening wedge osteotomy without a graft

Background: This study evaluated the use of biplanar medial opening wedge high tibial osteotomy for correction of adolescent tibia vara. This technique is used successfully in correction of genu varum deformity associated with degenerative knee osteoarthritis. Methods: Twenty-two patients with adolescent tibia vara underwent medial opening wedge high tibial osteotomy without bone grafting. Eight patients had bilateral tibia vara. Twelve were boys and 10 were girls. Radiographs were obtained preoperatively and the mechanical tibiofemoral angle (mTFA), mechanical lateral distal femoral angle (mLDFA) and mechanical medial proximal tibial angle (mMPTA) were measured before and after correction. Results: All osteotomies healed within 10 wk. The mTFA was corrected from an average of 13.6 degrees (9-23 degrees) to within 2.6 degrees from normal mechanical tibiofemoral alignment. The mMPTA was corrected from an average of 76.7 degrees (68-81 degrees) to an average of 88 degrees (86-91 degrees) postoperatively. No neurovascular complications or wound infection occurred. There was only one recurrence that required an additional osteotomy leading to a satisfactory result. Conclusions: Medial opening wedge high tibial osteotomy without a bone graft is a simple, reproducible method for correction of mild to moderate adolescent tibia vara.

Comparison the time to stabilization and activity of the lower extremity muscles during jump-landing in subjects with and without Genu Varum

BackgroundKnee muscles activity changes from Genu Varum deformity(GVD), may cause this individual more exposed to lower extremity injuries especially in high-risk activities like landing. ObjectiveThe aim of this study was to compare the activity of the lower limb stabilizer muscles during jump-landing and time to stabilization(TTS) in subjects with and without GVD. MethodA total of 44 men (group 1, with GVD n = 22 and group 2, without GVD n = 22); with mean age = 17.6 ± 3.12 years, height = 178.2 ± 5.39 cm, mass = 80.39 ± 8.3 kg) participated in this study.Subjects were asked to do a jump-landing task and Quadratus Lumborum(QL), Gluteus Maximus(GMax), Gluteus Medius(GMed), Biceps Femoris (BF), Semitendinosus, and Medial Gastrocnemius(MG) muscles activity was recorded. Also, changes in the amount of ground reaction force(GRF) were used to an indicator for TTS. ResultsOur results showed that subjects with GVD had increased QL activity before(P = 0.008) and after(P = 0.017) landing. But, these subjects had a decreased activity of GMed compared to the healthy ones before(P = 0.033) and after(P = 0.005) landing. but there was no statistically significant difference before landing in gluteus maximus(P = 0.252), biceps femoris(P = 0.613), semitendinosus(P = 0.313), and medial gastrocnemius(P = 0.140) muscles and after landing in gluteus maximus (P = 0.246), biceps femoris(P = 0.512), semitendinosus(P = 0.214), and medial gastrocnemius(P = 0.209) muscles between the two groups. Also, the TTS was higher in subjects with GV than healthy ones in the Resultant Vector TTS (P = 0.015) and medial-lateral(P = 0.013) directions. ConclusionsThe altered activity of the QL and GMed, in subjects with GVD may indicate instability of the spinal column, pelvis and hip during jump-landing task. Although the GVD is referred to the frontal plane deformity, the results showed that this complication might affect stability in other motion planes.

Advances in the treatment of medial meniscus posterior root tear

With the continuous progress of diagnosis and technology on knee osteoarthrosis, the concept of stepwise treatment and keeping meniscus as much as possible has been deeply rooted in people's minds. As an important anatomical structure for maintaining the annular tension of the medial meniscus of the knee, more and more attention has been paid to the posterior root. After the root tear of the medial meniscus, the annular tension loss, leading to the meniscus bearing load function partial or complete loss, and secondary knee medial space narrow, cartilage degeneration and genu varus deformity. In the of root tear of the medial meniscus different scholars hold different views. The of the medial meniscus posterior root tear of the knee is mainly conservative and operative treatment, and the conservative mainly includes non-steroidal drugs, functional exercise, physical therapy, and so on. The surgical mainly included the medial meniscus partial resection of the medial meniscus under the arthroscope, the medial meniscus posterior root repair under the arthroscopy, and osteotomy with medial meniscus posterior root repair under the arthroscopy. Despite the short-term curative effect of conservative therapy and resection is satisfied, long-term follow-up has no obvious improvement with knee pain, function and activity levels, and causes secondary biomechanical change of knee. For patients of age 90°) genu varus >5°, osteotomy can effectively improve the clinical curative effect. However, whether to repair the medial meniscus posterior root together is still controversial.

Acute correction of proximal tibial varus deformity in adolescent Blount disease with a low-profile Ilizarov frame

Background: Adolescent tibia vara usually presents with genu varum deformity and is commonly associated with internal tibial torsion. The Ilizarov technique is one of the accepted techniques for correction of this deformity. Acute correction has the advantage of a shorter duration in the fixator and less patient discomfort. Using the Ilizarov construct with two rings decreases bulkiness of the frame and improves compliance. Methods: Thirteen male patients with adolescent Blount disease, seven of whom had bilateral deformities (total 20 knees), were managed by extra-focal tibial valgus lateral translation osteotomy with a low- profile Ilizarov frame fixation. The frame was removed after full union, and patients were followed-up for 18 mo. Patients were assessed clinically using intercondylar distance and radiographically by measuring the distal lateral femoral angle and proximal medial tibial angle on CT scanogram. Results: All patients achieved correction of the tibial varus deformity. The intercondylar distance improved from 12.1 cm on average preoperatively to 5 cm on average postoperatively. The mean preoperative deviation of the medial proximal tibial angle was 22 degrees while the mean postoperative deviation was 2.4 degrees (ranging from 0-8.5 degrees). The mean duration to union of the osteotomy was 9 wk (range, 7-10 wk). Pin track infection occurred in 8 limbs. Conclusions: Extra-focal percutaneous valgus lateral translation osteotomy and fixation with a low-profile Ilizarov frame allows accurate deformity correction, shorter duration in the fixator, and better patient comfort and satisfaction.

Anatomical Alignment of Lower Extremity in Subjects With Genu Valgum and Genu Varum Deformities

Anatomical Alignment of Lower Extremity in Subjects With Genu Valgum and Genu Varum Deformities

Validité de la mesure peropératoire de l’antéversion de la pièce fémorale et facteurs d’erreur dans l’arthroplastie totale de hanche non cimentée par voie postéro-latérale

BackgroundIntraoperative estimation of stem anteversion in total hip arthroplasty (THA) using postero-lateral approach is made by the surgeon's visual assessment, using the tibia as a guide, with the assumption that tibial axis is vertical to the trans-epicondylar axis. However, the accuracy of the intraoperative estimation has rarely been verified with postoperative CT-scans, with controversies regarding these measurements particularly in case of knee osteoarthritis. Therefore, we performed a prospective study to: (1) determine the accuracy of the intraoperative measurement and (2) investigate factors affecting the discrepancy between the surgeon's estimation and the real stem anteversion. HypothesisIntraoperative estimation of stem anteversion correlated with the real stem anteversion on CT scan. Patients and methodsSixty-seven THAs using cementless straight stems (65 patients) without ipsilateral total knee arthroplasty were prospectively evaluated to compare the intraoperative measurement of stem anteversion with the real stem anteversion on computed tomography (CT) scans. There were 33 men and 34 women with a mean age of 59.7 years (range, 27–84 years) at the time of surgery. Age, tibia plateau angle, native femoral anteversion, femoro-tibial angle, body mass index, operative site, gender, coronal and sagittal tilt of the stem, stem type, ipsilateral knee osteoarthritis, and preoperative diagnosis were analyzed to evaluate the factors affecting the discrepancy between the intraoperative and CT measurements. ResultsThe intraoperative estimation (mean, 21.5°±8.5°; range, 5.0°–39.0°) was greater than the CT measurement (mean, 19.5°±8.7°; range, 4.5°–38.5°) by 2.0°. The mean absolute value of discrepancy was 4.5°. The correlation coefficient between intraoperative and CT measurements was 0.837. The femoro-tibial angle was associated with the discrepancy between the two measurements. In the presence of genu varum deformity, the intraoperative measurement underestimated the stem anteversion. DiscussionAlthough intraoperative estimation of stem anteversion was slightly greater than the real stem anteversion, there was an excellent correlation between the two. The femoro-tibial angle should be considered to optimize the stem anteversion during cementless THA using postero-lateral approach. Level of evidenceIII, prospective case control study.

Pelvic, Hip, and Knee Kinematics of Stair Climbing in People with Genu Varum

Purpose: This study examined the effects of the lower limb alignment on the pelvis, hip, and knee kinematics in people with genu varum during stair walking. Methods: Forty subjects were enrolled in this study. People who had intercondylar distance ≥4cm were classified in the genu varum group, and people who had intercondylar distance <4cm and intermalleolar distance <4cm were placed in the control group. 3D motion analysis was used to collect the pelvis, hip, and knee kinematic data while subjects were walking stairs with three steps. Results: During stair ascent, the genu varum group had decreased pelvic lateral tilt and hip adduction at the early stance phase and decreased pelvic lateral tilt at the swing phase compared to the control group. At the same time, they had decreased minimal hip adduction ROM at the early stance and decreased maximum pelvic lateral tilt ROM and minimum hip rotation ROM at the swing phase. During stair descent, the genu varum group had decreased pelvic lateral tilt at the early stance and decreased pelvic lateral tilt and pelvic rotation at the swing phase. In addition, they had decreased pelvic frontal ROM during single limb support and increased knee sagittal ROM during the whole gait cycle. Conclusion: This study suggests that a genu varum deformity could affect the pelvis, hip and knee kinematics. In addition, the biomechanical risk factors that could result in the articular impairments by the excessive loads from lower limb malalignment were identified.

Knee society score, mechanical tibiofemoral angle and the Fujisawa point: Do these variables determine a successful outcome of a high tibial osteotomy using an ilizarov fixator about the knee for medial compartmental osteoarthritis

Introduction: Medial compartment Osteoarthritis is an age related chronic disturbance of weight distribution over the articular surface of the knee joint. The compensatory Varus deformity which develops leads to “bowing” of the legs. Traditionally, treatment involved conservative regimen of analgesics, physiotherapy and lifestyle modifications. Before the advent of Arthroplasty, Osteotomies were the mode the treatment. The treatment modality is divided into two phases. The first phase involves in correcting the mechanical axis deviation, through a high Tibial Osteotomy. The second phase involves stabilizing this accomplishment with an Ilizarov external fixator and achieving the co-linearity of the Mechanical axis of the lower extremity through angular correction using distraction Osteosynthesis. Aim: The aim of present study was to evaluate the results of High Tibial osteotomy using Ilizarov technique in medial compartment osteoarthritis of the knee. Materials and Methods: In this prospective study, thirty cases of medial compartment osteoarthritis of the Knee with genu Varus deformity were treated using monofocal corticotomy and ring fixator. Bone and functional results were evaluated clinically using the Knee Society score (knee score and functional score) and radiologically using the mechanical tibiofemoral angle and the Mechanical axis deviation from the Fujisawa point. Results and Discussion: In the present series of thirty cases, there were 20 females and 2 males with a maximum age of 52 years and minimum of 32 years. There was a predominance of Varus deformity seen on the right knee. The mean follow up was 30 months. The results observed were 60% excellent, 33% fair and 6.7% poor by knee society score. The mean knee society score (Knee score) at 12 months was 71.27 ± 5.32 (p

Results with nine years mean follow up on one hundred and three KAPS® uni knee arthroplasties: eighty six medial and seventeen lateral.

The purpose of this study was to present the results of the KAPS® uni knee arthroplasty system, both mobile and fixed bearing with reference to function, alignment and complications in 103 implants with a mean follow-up of nineyears. This was a retrospective study of 103 unicompartimental knee arthroplasties in 89 patients operated on between March 2005 and March 2010. The population was composed of 50 males and 39 females, with a mean age of 70.5 ± 7.5years (41 - 90). Eighty-seven patients had a genu varum deformity (84.5%), one of whom had an osteoid osteoma of the lateral tibial plateau and 16 patients had a genu valgum (15.5%). Eighty-six medial prostheses were implanted (82 mobile bearings and 4 fixed bearings) and 17 lateral prostheses (all fixed bearings) including the osteoid osteoma. At a mean follow-up of 107.5months (73-138), 72 knees (58 patients) were reviewed (70%). The mean IKS score was of 173 ± 31 points (58 - 200). The mean Oxford knee score was 21 ± 8 points (12 - 50). The cumulated survival rate at a follow up of 132months was 98.2%. The KAPS® unicompartmental knee arthroplasty gives efficacious and safe outcomes in the majority of cases at a mean follow-up of nineyears. The availability of both fixed and mobile bearings with the same instrumentation, allowing to choose the right implant intra-operatively, is a great advantage in order to avoid the occurrence of some complications, specific to mobile bearing prostheses (dislocation and over-correction).

Computer-Assisted Osteotomies for Genu Varum Deformity : Rationale, Surgical Technique, Outcome and Return to Sports

Computer-Assisted Osteotomies for Genu Varum Deformity : Rationale, Surgical Technique, Outcome and Return to Sports

Effect of Genu Varum Deformity on Gluteus Medius Muscle Activity and Postural Control During Single-Leg Jump-Landing

Effect of Genu Varum Deformity on Gluteus Medius Muscle Activity and Postural Control During Single-Leg Jump-Landing

The Comparison of the Pattern and Activity of Selected Muscles of the Lower Extremity in Athletes with Genu Varum and Healthy Athletes during Running: A Case-Control Study

Introduction: Malalignment of the lower extremity, especially at the knee, can lead to injury due to its impact on muscle activity. Therefore, the aim of the present study was to compare the pattern and activity of selected muscles of the lower extremity in athletes with genu varum and healthy athletes during running. Materials and Methods: The present quasi-experimental study was conducted on 30 male athletes (two groups of genu varum and healthy) with the age range of 20-25 years. The amount and the time of onset of muscle activity were calculated using electromyography (EMG). To evaluate differences between and within groups, MANOVA and paired samples t-test were utilized, respectively, at the 0.05 level of significance. Data were analyzed in MATLAB and SPSS software. Results: The results showed that the gluteus medius muscle in the athletes with genu varum had significantly higher levels of activity compared to the control group in the dominant (P = 0.032) and non-dominant limbs (P = 0.039). However, the rectus femoris and medial gastrocnemius muscles’ activity was not significantly different between the two groups (P > 0.050). In addition, there was no significant difference between the groups in terms of onset of muscle activity (P > 0.050). Moreover, no significant difference was observed between dominant and non-dominant limbs in the amount and onset of muscle activity (P > 0.050). Conclusion: Based on the results of this study, it can be concluded that the gluteus medius muscle had greater activity in subjects with genu varum deformity than healthy subjects. This increase in activity can be accompanied with increase in compressive forces and articular loads which can cause osteoarthritis in the long run.

Simultaneous bilateral correction of genu varum with Smart frame.

The aim of this study is to evaluate clinical and radiological results of simultaneous bilateral correction of genu varum with Smart frame. Between 2011 and 2015, a total of 25 patients (10 females, 15 males) who had bilateral genu varum deformity were operated bilaterally with tibial and fibular osteotomy in the same session, using Smart frame. The mean follow-up period was 28.7 (range, 13-45) months. All patients had bilateral tibial varus deformity. Femoral deformity was corrected in an earlier session in nine patients. Mechanical axis deviation (MAD), mechanical lateral distal femoral angle, mechanical medial proximal tibial angle (mMPTA) and posterior proximal tibial angle (PPTA) were measured preoperatively and postoperatively. Short Form-36 questionnaire was filled by the patients preoperatively and during the last follow-up. The mean preoperative MAD was 37.6 mm (range, 9-98 mm), which improved to 8.4 mm (range, 3-44 mm) postoperatively ( p < 0.05). The mean preoperative mMPTA was 76°, which improved to 89° ( p < 0.05). The mean preoperative PPTA was 75.5°, which improved to 80.3 ( p < 0.05). Ten problems (20%), two obstacles (4%) and no sequelae occurred in 50 legs of 25 patients. In conclusion, Smart frame is an accurate and reliable method for performing bilateral simultaneous deformity correction in patients with bilateral genu varum deformity. It can be applied for various childhood-induced severe tibial deformities such as achondroplasia, rickets, skeletal dysplasia and Blount's disease.

A Rare Association of Rheumatoid Arthritis with Crohn’s Disease

Crohn’s disease (CD) is an chronic autoimmune inflammatory bowel disease (IBD) which may involve any part of the gastrointestinal system (GIS) (1). Although the rellationships among autoimmune diseases are known, association of rheumatoid arthritis (RA) and CD is an extremely rare condition (2,3). A 50-year-old male patient who had the diagnosis of seropositive RA for 5 years, presented with the complaints of bloody diarrhea and abdominal pain. The RA treatment had been regulated as a combination of methotrexate, sulfasalazine and hydroxychloroquine, and the patient reported that he was regularly taking the medical therapy. In joint examination, metacarpophalangeal joint arthritis were found bilateral. No hand deformity was observed. In physical examination, there were no findings except tenderness in the lower abdominal quadrants. There was not any bacterial growth in the stool culture. The results of the colonoscopy, found inflammation in the ileum (Figure 1a, 1b). Histopathologic examination was compatible with CD. Anteroposterior hand radiography revealed narrowing in 3rd and 4th proximal interphalengeal joints (Figure 1c). Genu varum deformity was found in the knee and magnetic resonance imaging (MRI) revealed synovial hypertrophy. Biochemical analysis yielded sedimentation rate as 22 mm/h (Reference range: 0-20 mm/h), C-reactive protein 1.21 mg/dL (reference range: 0-0.5 mg/dL), rheumatoid factor (+) and anti cyclic citrullinated peptide (CCP) (+). Mesalazine and azathioprine were added to his treatment protocol. At follow-up, complaints of the patiens gradually regressed within 4 months. Articular system involvement is commonly seen in IBD such as ulcerative colitis (UC) and CD. Axial and peripheral articular findings may commence before, concurrently or after the diagnosis of IBD. Peripheral arthritis is generally in form the oligoarticular involvement of the large joints. However, in a small portion of IBDs, an arthritis form may be seen, resembling rheumatoid arthritis and often affecting the small joints of the hand symmetrically and polyarticularly (4). Peripheral arthritis is reported in CD by 10-20% which is more frequent compared to UC (5). Our patient was diagnosed with CD, suggesting us the joint findings may be occured due to this condition. However, IBD arthritis is seronegative and never or rarely causes joint destruction compared to RA (5). In our patient, arthritis had begun about 5 years before GIS symptoms. According to 2010 American College of Rheumatology/European League Against Rheumatism criteria, positivity of anti CCP, RF antibodies, marked synovial hypertrophy in the knees on MRI and narrowing of the joint spacing found in our patient confirmed the diagnosis of RA. Our patient who could not describe an association between the exacerbation of CD and arthritis gave positive response to RA treatment. Hatice Resorlu, Erdem Akbal*, Ferhat Gokmen, Yilmaz Savas