van Erp S J, Brakenhoff L K, van Gaalen F A, van den Berg R, Fidder H H, Verspaget H W, Huizinga T W, Veenendaal R A, Wolterbeek R, van der Heijde D, van der Meulen-de Jong A E, Hommes D W
Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands.
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
J Crohns Colitis. 2016 Feb;10(2):166-75. doi: 10.1093/ecco-jcc/jjv195. Epub 2015 Oct 28.
Peripheral joint complaints [pJTC] and chronic back pain [CBP] are the most common extra-intestinal manifestations in patients with inflammatory bowel disease [IBD]. This prospective study evaluates variables associated with joint/back pain, including IBD disease activity.
IBD patients with back pain ≥ 3 months and/or peripheral joint pain/swelling [n = 155], and IBD patients without joint complaints [n = 100; controls], were followed for a period of 1 year. Patients were classified as having SpondyloArthritis [SpA] according to several sets of criteria. Statistical analysis included logistic regression models and linear mixed model analysis.
Of the 155 patients with joint/back pain, 13 had chronic back pain, 80 peripheral joint complaints, and 62 axial and peripheral joint complaints. Smoking, female gender, and IBD disease activity were independently associated with IBD joint/back pain. The Assessment in Spondyloarthritis International Society criteria for axial and peripheral SpA were fulfilled in 12.3% of patients, with 9.7% [n = 15] receiving a rheumatological diagnosis of arthritis. During the 12-month follow-up, the majority of the patients reporting joint/back pain remained stable.
In our cohort, the majority of IBD patients reported joint/back pain and SpA was relatively common. To facilitate effective care, gastroenterologists should be aware of the various features of SpA to classify joint complaints and, by making use of an efficient referral algorithm, to refer CBP patients to the rheumatologist.
外周关节症状（pJTC）和慢性背痛（CBP）是炎症性肠病（IBD）患者最常见的肠外表现。本前瞻性研究评估与关节/背痛相关的变量，包括IBD疾病活动度。
对背痛≥3个月和/或外周关节疼痛/肿胀的IBD患者（n = 155）以及无关节症状的IBD患者（n = 100；对照组）进行为期1年的随访。根据多套标准将患者分类为患有脊柱关节炎（SpA）。统计分析包括逻辑回归模型和线性混合模型分析。
在155例有关节/背痛的患者中，13例有慢性背痛，80例有外周关节症状，62例有轴向和外周关节症状。吸烟、女性性别和IBD疾病活动度与IBD关节/背痛独立相关。12.3%的患者符合国际脊柱关节炎协会轴向和外周SpA的评估标准，9.7%（n = 15）的患者获得了关节炎的风湿病诊断。在12个月的随访期间，大多数报告有关节/背痛的患者病情保持稳定。
在我们的队列中，大多数IBD患者报告有关节/背痛，SpA相对常见。为了提供有效的治疗，胃肠病学家应了解SpA的各种特征以对关节症状进行分类，并通过使用有效的转诊算法，将CBP患者转诊给风湿病学家。
