Enteropathic Arthritis

Also known as: IBD-associated arthritis

Inflammatory arthritis linked to Crohn’s disease or ulcerative colitis, affecting the limbs, the spine or both.

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How it works · Inflammatory arthritis

A healthy joint

Smooth cartilage caps the bone ends, and a thin lining called the synovium makes fluid that keeps the joint gliding.

What it is

Up to one in four people with inflammatory bowel disease develop joint inflammation. Some have arthritis in large joints that flares with gut activity, while others have spinal inflammation that runs its own course.

Symptoms

Swollen, painful knees, ankles or other joints, inflammatory back pain, heel pain, and sometimes eye inflammation or skin lesions such as erythema nodosum.

How it’s diagnosed

Your rheumatologist reviews joint and back symptoms alongside your bowel history, inflammatory markers and imaging such as MRI of the sacroiliac joints. Coordination with your gastroenterologist is key.

Treatment

Controlling the gut disease often settles limb arthritis. TNF inhibitors such as infliximab and adalimumab treat both bowel and joints. NSAIDs are used cautiously since they can aggravate bowel disease.

Living with it

Shared care between rheumatology and gastroenterology works best. Keep up with vaccines, and with bone health checks if you take steroids.

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Reactive Arthritis →

At a glance