RT Book, Section
A1 Kasper, Dennis L.
A1 Fauci, Anthony S.
A1 Hauser, Stephen L.
A1 Longo, Dan L.
A1 Jameson, J. Larry
A1 Loscalzo, Joseph
SR Print(0)
ID 1128787551
T1 Other Musculoskeletal Disorders
T2 Harrison's Manual of Medicine, 19e
YR 2016
FD 2016
PB McGraw-Hill Education
PP New York, NY
SN 9780071828529
LK accessmedicine.mhmedical.com/content.aspx?aid=1128787551
RD 2024/04/16
AB Both  peripheral  and  axial  arthritis  may  be  associated  with  the  inflammatory  bowel  diseases  (IBD)  of  ulcerative  colitis  or  Crohn's  disease.  The  arthritis  can  occur  after  or  before  the  onset  of  intestinal  symptoms.  Peripheral  arthritis  is  episodic  and  asymmetric;  it  most  frequently  affects  knee  and  ankle.  Attacks  usually  subside  within  several  weeks  and  characteristically  resolve  completely  without  residual  joint  damage.  Enthesitis  (inflammation  at  insertion  of  tendons  and  ligaments  into  bone)  can  occur  with  manifestations  of  "sausage  digit,"  Achilles  tendinitis,  and  plantar  fasciitis.  Axial  involvement  can  manifest  as  spondylitis  and/or  sacroiliitis  (often  symmetric).  Laboratory  findings  are  nonspecific;  rheumatoid  factor  (RF)  absent;  HLA-B27  is  positive  in  70%  with  IBD  and  axial  disease  but  <15%  with  IBD  and  peripheral  arthritis;  radiographs  of  peripheral  joints  usually  normal;  axial  involvement  is  often  indistinguishable  from  ankylosing  spondylitis.