From bowel inflammation to the bone and joints: musculoskeletal examination in inflammatory bowel disease (IBD)

• Published in: BMC musculoskeletal disorders Vol. 22; no. 1; pp. 1 - 1019
• Main Authors: Tavassoli, Samane, Shahabinasab, Iman, Norouzi, Alireza, Amiriani, Taghi, Abdolahi, Nafiseh, Livani, Somayeh, Mirkamali, Seyed Farzam, Mirkarimi, Honey Sadat, Amlashi, Fazel Isapanah, Besharat, Sima
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 04-12-2021; BioMed Central; BMC
• Subjects: Arthritis; Asymptomatic; Back pain; Complications and side effects; Dactylitis; Diagnosis; Enthesitis; Inflammatory bowel disease; Inflammatory bowel diseases; Intestine; Joint diseases; Low back pain; Medical imaging; Musculoskeletal diseases; Musculoskeletal system; Remission (Medicine); Risk factors; Sacroiliitis; Sclerosis; Statistics; Steroids; Thorax; Iran; New York; Canada; Italy; United States > US
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-021-04903-4

Abstract
Background
One of the most important complications in inflammatory Bowel Disease (IBD) are musculoskeletal manifestations that are reported in more than 50% of patients.
Objectives
In this study, we aimed to evaluate the musculoskeletal and radiologic manifestations in our IBD patients.
Methods
In this cross-sectional study on 96 mild-to-moderate IBD patients (76 UC, 18 CD and 2 undifferentiated IBD) with mean (SD) age of 39.28 (11.42) years, 44 (45.8%) were males and 52 were (54.2%) females. Patients were examined by an expert rheumatologist and their musculoskeletal symptoms were assessed. The musculoskeletal system was evaluated by Modified Schober test, Thoracic expansion (TE), Occiput to wall distance (OWD), and Patrick’s or FABER test. Peripheral joints were also examined in all four extremities. Then patients were referred for pelvic and lumbosacral x-ray. Sacroiliitis grading was performed using the New York criteria.
Results
Inflammatory low back pain was reported in 5 (5.2%), enthesopathy in 6 (6.5%) and dactylitis in 1 (1.1%). Positive Schober test was recorded in 5 (5.2%) and Patrick test in 3 (3.1%). Forty-nine (51%) cases had normal imaging with no sacroiliitis, endplate sclerosis was seen in 33 cases (34.4%), grade 3 and grade 4 were seen in 10 cases (10.4%).
Conclusions
In the present study, 34.4% of the IBD patients had mild radiologic changes as endplate sclerosis and 95% had a normal physical examination.