Background Extraintestinal manifestations occur rather frequently in inflammatory bowel disease (IBD). Rheumatic manifestations are the most common and are associated with a wide range of clinical patterns.
Objectives To estimate the prevalence of joint manifestations in chronic inflammatory bowel disease and to identify risk factors of their occurrence.
Methods Cross-sectional study of 114 cases of IBD collected in gastroenterology and rheumatology departments of a Moroccan teaching hospital on a period of 9 months (from April 2009 to December 2010). Data were analyzed using SPSS. A multivariate logistic regression was used.
Results Seventy-three women and fourty-one men were included in the study. Their mean age was 38.5±14 year. IBD onset was at an average age of 35±14 years. Fifty-two patients were diagnosed with ulcerative colitis (UC) and 62 with Crohn’s disease. Joint manifestations were present in 71.1% of cases. The prevalence of axial involvement, peripheral involvement, and enthesis involvement were 72.8%, 90.1% and 40.7% respectively. Radiological changes were identified in 52.63% of cases; 7.9% of patients had isolated asymptomatic sacroiliitis. 52.6% of cases satisfied the criteria of The European Spondyloarthropathy Study Group (ESSG), 28.1% of them satisfied the modified New York criteria. In univariate analysis, factors associated with joint damage were female gender, CRP>10 mg/l, high ESR and extensive UC. In multivariate analysis, only female sex (OR =3.02 [95% CI: 1,14-8]), CRP>10 mg/l (OR =5.51 [95% CI: 1,39-21, 82]) and high ESR (OR =9.18 [95% CI: 1,80-46, 83]) were selected as predictors of joint damage in IBD.
Conclusions Musculoskeletal involvements are the most important extra digestive manifestations of IBD. Compared with the North African series, our results highlight the predominance of peripheral versus axial arthritis. Their screening should be systematic for patients with IBD especially if they are female and if they have a biological inflammatory syndrome, allowing early diagnosis and better treatment.
Disclosure of Interest None Declared
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