Department of Medicine, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
Curr Rev Musculoskelet Med. 2011 Sep;4(3):123-31. doi: 10.1007/s12178-011-9085-8.
Arthritis is the most common extraintestinal manifestation of inflammatory bowel disease (IBD) and can have a significant impact on morbidity and quality of life. IBD-associated arthropathy is considered a subtype of seronegative spondyloarthropathy, with axial, peripheral, or a combination of both joint manifestations. Peripheral arthritis is generally non-erosive and the oligoarticular variant particularly may correlate with intestinal disease activity. Axial arthritis may include inflammatory back pain, sacroiliitis, or ankylosing spondylitis, and is less likely to correlate with gastrointestinal symptoms. While there have been advances in identifying predisposing genetic factors and in elucidating pathophysiology of inflammatory bowel disease, the mechanisms surrounding the development of arthritis in IBD remain unclear. Treatment of inflammatory bowel disease is not always sufficient for control of arthritis. While treatment with biologic agents is promising, there remains a great need for larger, randomized studies to address optimal therapy of IBD associated arthropathy.
关节炎是炎症性肠病（IBD）最常见的肠外表现，可显著影响发病率和生活质量。与 IBD 相关的关节病被认为是血清阴性脊柱关节病的一个亚型，具有轴性、外周性或两者混合的关节表现。外周关节炎通常是非侵蚀性的，寡关节炎变异型可能与肠道疾病活动特别相关。轴性关节炎可能包括炎症性背痛、骶髂关节炎或强直性脊柱炎，与胃肠道症状的相关性较低。虽然在确定易患遗传因素和阐明炎症性肠病的病理生理学方面已经取得了进展，但 IBD 中关节炎发展的机制仍不清楚。炎症性肠病的治疗并不总是足以控制关节炎。虽然生物制剂的治疗有前景，但仍需要更大规模的随机研究来解决与 IBD 相关的关节病的最佳治疗方法。
