Sacro-iliitis and Ulcerative Colitis

Abstract

A prospective survey into the frequency of sacro-iliitis and changes in the lumbar spine in 234 unselected patients with ulcerative colitis has been carried out. Combined assessment by a gastro-enterologist and a rheumatologist made it possible to correlate the radiological changes with colitic and arthritic symptoms and signs. The x-ray changes in the sacro-iliac joints were compared with a matched control population. Fifteen patients had ankylosing spondylitis clinically. Forty-two (18%) had sacro-iliitis radiographically, a highly significant increase in incidence compared with the control population. Sacro-iliitis was present equally commonly in both sexes, but erosive changes occurred twice as often among women. The incidence of sacro-iliitis bore no striking relation to the colonic disease in its duration, extent, clinical type, or complications, unlike colitic arthritis. It was not related to uveitis, nor to ulceration of the buccal mucosa. There was a positive correlation with skin lesions and colitic arthritis. The significance of these findings in relation to other forms of arthritis occurring with diseases of the bowel is discussed and the suggestion that colitic arthritis is a manifestation of ankylosing spondylitis is examined. © 1965, British Medical Journal Publishing Group. All rights reserved.