Mwandishi:
Mhariri:
Imeboreshwa:
ULY CLINIC
ULY CLINIC
20 Oktoba 2026, 12:37:49
Enteropathic arthritis (arthritis with inflammatory bowel disease)
20 Oktoba 2026, 12:37:49
Peripheral arthritis (type 1: under 5 joints, flares with IBD; type 2: 5 or more joints, independent of IBD), sacroiliitis/spondylitis, enthesitis, dactylitis, uveitis, erythema nodosum, pyoderma gangrenosum.
Diagnosis: confirmed IBD + arthritis + negative RF and anti-CCP; ESR/CRP, colonoscopy, X-ray/MRI of sacroiliac joints, HLA-B27.
Management
Physiotherapy, nutritional support, control of the IBD.
NSAIDs can worsen IBD – lowest dose, short course, prefer COX-2-selective: D: meloxicam 7.5–15 mg once daily, OR C: celecoxib 100–200 mg every 12 hours, OR S: etoricoxib 30–60 mg once daily.
Peripheral arthritis: D: sulfasalazine (PO) 500 mg every 12 hours, increased by 500 mg weekly to 2–3 g/day in divided doses, OR S: Methotrexate (PO) 15–25 mg once weekly AND A: folic acid (PO) 5 mg weekly (not on the methotrexate day) (more used in Crohn's disease).
Moderate–severe or axial: S: adalimumab (SC) 40 mg every 2 weeks.
Flares: A: prednisolone 5–10 mg once daily (short course), OR S: triamcinolone 10–40 mg deep IM monthly or intra-articular.