Objectives Musculoskeletal manifestations in patients with inflammatory bowel disease (IBD) are common and associated with poorer outcomes. Hence, early detection is important to optimally tailor treatment. We aimed to determine the prevalence and distribution of inflammatory lesions in peripheral joints and entheses in newly diagnosed IBD patients. Design Patients with newly diagnosed IBD from a prospective population-based inception cohort were consecutively included. Data on musculoskeletal symptoms were collected by questionnaires and by structured rheumatological interview. Peripheral joints and entheses were assessed clinically and by ultrasound (US), using standardized definitions. Results Of 110 included patients (mean age: 42 years, 40% male, 70 with ulcerative colitis (UC), 40 with Crohn’s disease (CD)), history of ≥1 musculoskeletal symptoms was reported by 49%. Clinical examination revealed peripheral musculoskeletal manifestations in 56 (52.3%) patients; 29 (27.1%) had ≥1 tender and/or swollen joints and 49 (45.8%) ≥1 tender entheses. Small peripheral joints were predominantly affected. US found inflammation in ≥1 joint or enthesis in 52 (49.5 %) patients; 29 (27.4 %) had US synovitis in ≥1 joint, while 36 (34%) US enthesitis. Fibromyalgia classification criteria were fulfilled in seven (7.9%) patients. There was no difference in clinical or US findings between patients with UC and CD, nor between patients with active and inactive IBD. Conclusion Half of patients with newly diagnosed IBD had inflammation in their peripheral joints and/or entheses, documented by rheumatological clinical and ultrasound evaluations. This indicates a need for multidisciplinary collaboration to ensure an optimal therapeutic strategy for suppressing inflammation in all disease domains.

中文翻译：

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新诊断的炎症性肠病患者的外周关节和附着点受累：症状、临床和超声检查结果——一项基于人群的队列研究

目标 炎症性肠病 (IBD) 患者的肌肉骨骼表现很常见，并且与较差的预后相关。因此，早期发现对于优化治疗非常重要。我们的目的是确定新诊断的 IBD 患者周围关节和附着点炎症病变的患病率和分布。设计连续纳入基于前瞻性人群的初始队列中新诊断 IBD 的患者。通过问卷调查和结构化风湿病学访谈收集肌肉骨骼症状的数据。使用标准化定义对周围关节和附着点进行临床和超声（美国）评估。结果 在 110 名纳入的患者中（平均年龄：42 岁，40% 为男性，70 名患有溃疡性结肠炎 (UC)，40 名患有克罗恩病 (CD)），49% 的患者报告有≥1 种肌肉骨骼症状史。临床检查发现 56 名（52.3%）患者存在周围肌肉骨骼表现；29 名（27.1%）有 ≥1 个关节压痛和/或肿胀，49 名（45.8%）有 ≥1 个附着点压痛。小的周围关节主要受到影响。US 在 52 名 (49.5%) 患者中发现≥1 个关节或附着点有炎症；29 名（27.4%）有 ≥1 个关节的 US 滑膜炎，而 36 名（34%）有 US 附着点炎。七名 (7.9%) 患者满足纤维肌痛分类标准。UC 和 CD 患者之间以及活动性和非活动性 IBD 患者之间的临床或超声检查结果没有差异。结论 根据风湿病临床和超声评估记录，一半新诊断 IBD 患者的外周关节和/或附着点有炎症。这表明需要多学科合作，以确保抑制所有疾病领域炎症的最佳治疗策略。