Review Article
Management of Musculoskeletal Manifestations in Inflammatory Bowel Disease
Table 2
Musculoskeletal manifestations in IBD.
| | Salient features | Prevalence |
| Peripheral arthropathies |
| Type 1 peripheral arthritis | Oligoarticular Asymmetric Large joints of lower extremities Self-limiting Nonerosive Parallels disease activity Associated with HLA-B27 carriage | 3.6–6% | Type 2 peripheral arthritis | Polyarticular Symmetric Small joints of upper extremities Progressive Erosive Independent of disease activity No association with HLA-B27 | 2.5–4% | Arthralgia without arthritis | Pain without swelling or erythema | 5.3–16% | Enthesitis | Pain and swelling at the tendon insertion site | 6–50% | Dactylitis | Pain and swelling of the entire digit | 2–4% |
| Axial arthropathies |
| Inflammatory back pain | Insidious onset Back pain lasting > 3 months After periods of inactivity Associated with stiffness No associated radiological findings | 17–22% | Isolated sacroiliitis | Imaging studies showing erosion, or sclerosis of the sacroiliac joints May be asymptomatic HLA-B27 negative | 16–46% | Ankylosing spondylitis | Combination of inflammatory back pain and imaging studies showing bilateral sacroiliitis grade ≥ 2 or unilateral sacroiliitis grades 3-4 | 1–11.4% |
| Other |
| Fibromyalgia syndrome | Generalized body pain for ≥3 months 11 out of 18 tender points | 3–3.7% | Osteopenia | BMD -score ≤ −1.0 | 32–36% | Osteoporosis | BMD -score ≤ −2.5 | 7–15% | Osteonecrosis | Marrow infarction Most common site head of femur | <0.5% | Myopathy | Multifactorial in etiology | Rare | Orbital myositis | Localized inflammation of extra-ocular muscles | Rare | Gastrocnemius myalgia syndrome | Calf pain as presenting complaint Gastrocnemius muscle involvement | Rare |
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BMD: bone mineral density. Table is reproduced from Sheth et al. [1] with permission from Lippincott Williams and Wilkins.
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