Prevalence of spondyloarthropathy in Puerto Rican patients with inflammatory bowel disease

Abstract

Introduction: Inflammatory arthritis is the most common extraintestinal manifestation in patients with inflammatory bowel disease (IBD). Approximately 20% of all IBD patients will present with peripheral arthritis, sacroiliitis, or spondylitis. The purpose of this study was to determine the prevalence of spondyloarthropathy and sacroiliitis in Puerto Rican patients with IBD.

Methods: Patients were obtained from the IBD specialty clinic and all had a diagnosis of ulcerative colitis or Crohn's disease. All the patients who agreed to participate were entered in the study. Patients completed a questionnaire and underwent a physical examination. Radiologic examination of the lumbosacral spine and sacroiliac joints was performed. Blood samples were obtained for determining human leukocyte antigen class I and were serologically analyzed in the pathology department laboratory. Data were analyzed by using SPSS 10.0 for Windows.

Results: One hundred patients were enrolled; 57% had ulcerative colitis, and 43% had Crohn's disease. Fifty percent were female, and the mean age was 37 years (standard deviation 14.96 years). Seventy-seven percent reported history of joint pain, and 47% reported limitation due to joint pain. Physical examination revealed peripheral synovitis in five patients and spinal tenderness in 46 patients. Of the 100 patients, 42 had inflammatory back pain and fulfilled the criteria for spondyloarthropathy. Radiographs were obtained in 76 patients. They revealed grade 2 or greater sacroiliitis in 10 patients (13%) and ankylosing spondylitis in two patients (2.6%). Of the 82 patients with blood samples, human leukocyte antigen B27 was found in five patients (6%).

Conclusions: Of the study population of Puerto Ricans with IBD, 42% had spondyloarthropathy. This prevalence is higher than reported in Caucasians (20%-30%). Sacroiliitis had a similar prevalence as reported in Caucasians, but the prevalence of peripheral arthritis was much lower.