[Severe backache in clinically inactive ulcerative colitis].

A 22-year-old man with a history of ulcerative colitis complained of progressive lower back pain that had persisted for more than one year and which finally confined him to bed. X-ray examination revealed sclerosis of the right sacroiliac joint, and of the 6th lumbar vertebra. An NMR examination revealed a diffuse signal loss in the region of the 6th lumbar vertebra. On account of the progressive increase in liver transaminases in the serum, an ERCP was carried out, which confirmed the suspected primary sclerosing cholangitis (PSC). Severe axial arthritis and PSC with underlying clinically inactive ulcerative colitis was diagnosed, and treatment with salazosulfapyridine and ursodeoxycholic acid initiated. This led to freedom from pain within a matter of weeks and an appreciable reduction in serum cholestasis parameters.