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Joint Pain and Inflammation in Crohn’s Disease and Ulcerative Colitis

It is not uncommon for people who have been diagnosed with Inflammatory Bowel Disease to experience joint pain with or without inflammation. Learn about the most common extraintestinal manifestation of IBD below!

Arthritis or Arthralgia?

Arthralgia

Arthralgia is joint pain that occurs without inflammation. Arthralgia has many causes including a serum-sickness like reaction to anti-TNF medications. 

Arthritis

Arthritis involves inflammation (usually accompanied by pain) in the joints. It is the most common extraintestinal manifestation in IBD occurring in about 30% of patients. In Crohn’s disease it affects about 15-20% of patients and in ulcerative colitis it affects about 10%. Arthritis usually occurs with arthralgia but not always; for instance patients with asymptomatic sacroiliitis which you will read about shortly. On the other hand it’s quite common for arthralgia to occur without arthritis. 

What have we learned so far

  • Arthritis is the most common extraintestinal manifestation of IBD, occurring in about 30% of IBD patients. 
  • Arthritis usually occurs with arthralgia but not always.
  • Joint pain (arthralgia) can occur, and often does, on it’s own without inflammation (arthritis).

Types of Arthritis Associated with IBD

Arthritis associated with Inflammatory Bowel Disease is commonly known as enteropathic arthritis. This type of joint inflammation can involve both axial and peripheral joints. Sometimes arthritis is the first symptom of IBD to show up and can preceed a diagnosis of IBD for a long time until it finally declares itself. Arthritis is more likely to occur in patients who have large bowel disease – either UC or CD located in the colon. People who have Crohn’s disease that affects the large bowel probably have the most arthritis. Below are the most common types of arthritis associated with IBD. 

Peripheral Arthritis 

About 60-70% of IBD-associated arthritis is peripheral arthritis. This kind of arthritis is not erosive and deforming and should do no long-term damage. Peripheral arthritis is most common in people who have ucerative colitis or Crohn’s disease that affects the large bowel and is classified into two types:


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