The Arthritis of Ulcerative Colitis

Abstract

A total of 269 unselected patients with ulcerative colitis have been investigated by a gastroenterologist and a rheumatologist in a forward-planned review to establish the frequency and nature of rheumatic complaints in this disease, and to correlate arthritic symptoms with those of colitis. The clinical and anatomical features of the colitic population studied are reported. Forty-five per cent. of patients had rheumatic complaints. Fifteen patients had ankylosing spondylitis; 31 (11.5%) developed a specific type of arthritis designated colitic arthritis. Colitic arthritis was equally common in the sexes, usually at ages 25 to 44. It was characterized by a recurrent acute synovitis, usually monarticular, asymmetrical, and beginning in a lower limb (commonly in a knee or ankle). The attack was usually of short duration and was unaccompanied by residual deformity or radiological change. Exacerbations of arthritis were usually associated with increased bowel symptoms. Patients with chronic ulcerative colitis involving the bowel extensively were more likely to develop colitic arthritis. The arthritis developed more often in patients with local or systemic complications of the colitis. Of 151 patients whose colitis had been treated surgically five had rheumatic complaints persisting after surgery. None were examples of colitic arthritis. In one patient the pains were apparently a result of sacro-iliitis which had developed during the course of the colitis. © 1965, British Medical Journal Publishing Group. All rights reserved.