Clinical features of enteropathic arthritis

In people with enteropathic arthritis, the clinical features of spondylitis (inflammation of the spine) and sacroiliitis (inflammation of sacroiliac joints) are indistinguishable from those of axial spondyloarthritis. Like other spondyloarthritides, the peripheral arthritis is oligoarticular, asymmetrical and predominantly affects the lower limbs. Enthesitis (inflammation at the sites of tendon and ligament attachment to bone) may be seen at the Achilles tendon and plantar fascia insertion.

Other extraintestinal features of inflammatory bowel disease that can be seen with enteropathic arthritis include:

• ocular complications, especially acute anterior uveitis, but also conjunctivitis and episcleritis—for more information on acute anterior uveitis and its management, see Clinical features of axial spondyloarthritis
• skin lesions, such as erythema nodosum (in Crohn disease) and pyoderma gangrenosum (in ulcerative colitis).

The spondyloarthritis may precede the clinical presentation of inflammatory bowel disease. As a general rule, spondylitis disease activity is independent of intestinal disease activity, whereas peripheral arthritis disease activity is often associated with intestinal inflammation.