This website uses cookies to give you the best experience. By continuing to use this website you are consenting to cookies being used. You can delete and block cookies from within your browsers settings. For more information please refer to our privacy and cookie policy page.


Inflammatory Bowel Disease

Inflammatory arthritis is common in inflammatory bowel disease (Crohn's disease and Ulcerative Colitis) and the joint problems can predate the bowel symptoms.

  • The arthritis involvement is often single or a small number of joints in the lower limb (knee, ankle or hip), and often asymmetrical.
  • There can be an association with HLA B27, enthesitis, acute uveitis (painful red eye).
  • The activity of the joint problems tend to fluctuate with the activity of bowel inflammation.
  • Inflammatory sacroiliitis (low back pain and morning stiffness) can also occur but tends to not fluctuate with activity of the bowel involvement. 

Inflammatory bowel disease should be suspected in a child with joint inflammation with one of more of the following scenarios:

  • anaemia or high platelets, high acute phase reactants.
  • systemic upset (weight loss, anorexia, poor growth). 
  • gastrointestinal symptoms (mouth ulcers, abdominal pain, change of bowel habit).
  • poor growth. 
  • acute uveitis and HLA B27. 
  • erythema nodosum.

Referral to gastroenterology is needed.

Management is often combined between paediatric rheumatology and paediatric gastroenterology.

Treatment involves immunosuppression (corticosteroids, methotrexate or sulphasalazine and some children require biologics). Joint injections may be useful.

The photograph below shows a swollen knee in an adolescent with Crohn's disease.

Site Statistics

To date (end of February 2021) PMM has >797,961 hits and >324,388 users from 217 countries!

Why register?

Some parts of pmm which involve pictures or videos of children, can only be viewed by registered users. Registering also allows you to bookmark favourite pages and track your viewing.

find out more

Short online courses

from Newcastle University, UK

e-resources from PMM

pmm for you

Please help us ensure pmm is as useful to you as possible by completing this short survey

complete survey