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. 2025 Oct 10;23(1):100.
doi: 10.1186/s12969-025-01141-z.

Musculoskeletal manifestations in children with inflammatory bowel disease: a multicenter cohort study (GASTROREUM study)

Adele Civino #  1 , Federico Diomeda #  2 , Romina Gallizzi  3 , Marco Gattorno  4 , Silvia Magni-Manzoni  5 , Davide Montin  6 , Gabriele Simonini  7 , Giovanni Conti  8 , Emanuela Del Giudice  9 , Giovanni Filocamo  10 , Fortunata Civitelli  11 , Angela Miniaci  12 , Serena Pastore  13 , Francesco La Torre  14 , Bianca Lattanzi  15 , Angela Mauro  16 , Lorenzo Mambelli  17 , Patrizia Barone  18 , Alma Nunzia Olivieri  19 , Gianluca Vergine  20 , Maria Cristina Maggio  21 , Ilenia Floretta  22 , Simona Campus  23 , Luca Cantarini  24 , Emanuela Sacco  25 , Michela Cappella  26 , Serena Arrigo  27 , Giusyda Tarantino  5 , Manuela Taurisano  28 , Silvia Greco  29 , Rossella Greco  30 , Fabrizio De Benedetti  5 , Francesca Bovis  31 , Angelo Ravelli  32   33 ; GastroReum Study group, and the Italian Society of Pediatric Rheumatology (ReumaPed)
Collaborators, Affiliations

Musculoskeletal manifestations in children with inflammatory bowel disease: a multicenter cohort study (GASTROREUM study)

Adele Civino et al. Pediatr Rheumatol Online J. .

Abstract

Background: Musculoskeletal (MSK) symptoms are the most common extra-articular manifestations of pediatric-onset inflammatory bowel diseases (pIBD), and are associated with a more aggressive disease course. This study aims to characterize MSK manifestations in patients with pIBD, and to seek for predictors of persistently active arthritis one year after pIBD diagnosis.

Methods: A multicenter, retrospective cohort study was conducted at 25 Italian pediatric rheumatology centers. Patients aged < 18 years with pIBD and MSK manifestations, followed for at least one year, were included. Data at onset of first MSK symptom, pIBD diagnosis, and one-year follow-up visit following pIBD diagnosis were collected.

Results: A total of 180 patients were included, 111 (61.7%) with Crohn’s disease (CD), 55 (30.5%) with ulcerative colitis (UC), and 14 (7.8%) with unclassified IBD (IBDU). Arthralgia (72.8%) and arthritis (69.4%), were the most frequent MSK manifestations. Patients with CD had MSK symptoms prior to pIBD diagnosis more frequently than those with UC/IBDU (51.4% vs. 40.6%). Among the 125 patients with arthritis, 76.8% had peripheral arthritis, 14.4% had axial disease, and 8.8% had both peripheral and axial involvement. The most common articular pattern was oligoarthritis (52.0%), followed by monoarthritis (26.4%) and polyarthritis (21.6%). The most frequently affected joints were the knee, ankle, and hip. On multivariable analysis, antinuclear antibody (ANA) positivity (OR = 3.05, 95% CI: 1.05 – 8.89) and a polyarticular course of arthritis (OR = 3.42, 95% CI: 1.13–10.38) were independently associated with persistence of active arthritis at year 1 after pIBD diagnosis.

Conclusions: Most patients with pIBD and arthritis presented with peripheral oligoarthritis affecting lower limb joints. A positive ANA status and development of polyarthritis predicted sustained arthritis activity.

Supplementary Information: The online version contains supplementary material available at 10.1186/s12969-025-01141-z.

Keywords: Antinuclear antibodies; Arthritis; Children; Inflammatory bowel disease; Juvenile idiopathic arthritis; Musculoskeletal; Sacroiliitis.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of [ASL Lecce, Italy (codex REUMAPED—28 August 2022)]. Consent for publication: Written informed consent was obtained from all participants and/or their legal guardians prior to enrollment. Competing interests: Co-Editor-in-Chief Angelo Ravelli is on the author list.

Figures

Fig. 1
Fig. 1
Frequency of joint involvement in 125 patients with pIBD and arthritis
See this image and copyright information in PMC

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