(above: monoarthritis in a patient with IBD)
Spondylitis and Sacroiliitis
- HLA B27 in 50-75% with axial arthritis
- Prolonged morning stiffness which improves with exercise
- Unrelated to GI disease...'disease discordant'
- Sacroiliitis may be asymptomatic
- Treatment: Back exercises, NSAIDs, maybe methotrexate
Peripheral arthritis
- Type 1
- Acute and pauciarticular peripheral arthritis
- Associated with flares of bowel disease....'disease concordant'
- Self limited with no joint deformity
- Knee most common site affected
- Type 2
- Polyarticular damage especially at MCPs
- Migratory
- Persist for months
- Can have exacerbations and remissions
- Treatment: NSAID/COX-2, sulfasalazine, methotrexate
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