Joint damage in children with inflammatory bowel diseases – experience of one center

Inflammatory bowel diseases, which include Crohn’s disease and ulcerative colitis, are systemic immunoinflammatory diseases. Among the extraintestinal manifestations of these diseases, musculoskeletal lesions with seronegative spondyloarthropathies are the most common.
The aim of the study was to evaluate the frequency and nature of joint lesions in patients with inflammatory bowel diseases observed at the Sechenov Centre for Maternity and Childhood in the period from 2017 to 2024.
Materials and Methods. The diagnoses of Crohn’s disease and ulcerative colitis were established in accordance with the clinical recommendations of the Union of Paediatricians of Russia. The classification criteria of the International Working Group on Ankylosing Spondylitis, 2011 and the Diagnostic Criteria for Juvenile Spondyloarthritis according to Garmisch–Partenkirchen, 1987 were used to verify the nature of joint damage. The prevalence of joint damage variants in the general group of children with inflammatory diseases of the intestine was analysed, as well as separately in groups with Crohn’s disease and ulcerative colitis.
Results. Of 175 children with inflammatory bowel disease, 77 (44%) had extraintestinal manifestations in the form of joint syndrome: 52 (68%) of them with Crohn’s disease and 25 (32%) with ulcerative colitis. Isolated arthralgias were noted in 7 of 77 children (9.1%). Of the 77 children, peripheral arthropathy in the form of oligoarthritis of large joints was noted in 64 (83.1%) patients, including 40 (62.5%) with Crohn’s disease and 24 (37.5%) with ulcerative colitis. Spondyloarthritis occurred in 6 (7.8%) children, in 5 children with Crohn’s disease and in 1 child with ulcerative colitis. Joint syndrome preceded intestinal manifestations of the disease in 40 (52%) of 77 patients with spondyloarthropathy.
Conclusions. The analysis of the prevalence of spondyloarthropathies in inflammatory bowel diseases in children showed its high frequency — 44%, significantly more often in Crohn’s disease. Among the patients with arthropathy associated with inflammatory bowel disease, the joint syndrome preceded the intestinal syndrome in 52% of cases. Peripheral oligoarthritis prevailed in 83.1% of our patients. Spondyloarthritis was detected in 7.8% of children, the vast majority of them with Crohn’s disease.

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