Abstract

The most frequent extra intestinal consequences of inflammatory bowel disease are musculoskeletal symptoms. Depending on the parameters used to identify spondylarthropathy, wide variations in prevalence have been recorded.The majority of the earliest epidemiological research on inflammatory bowel illness omitted cases of undifferentiated spondylarthropathies, which were included in the categorization criteria created in 1991 by the European Spondylarthropathy Study Group. All of the clinical characteristics of spondylarthropathies, including peripheral arthritis,inflammatory spinal pain, dactylitis, enthesitis (Achilles tendinitis and plantar fasciitis), buttock pain, and anterior chestwall pain, are included in the spectrum of musculoskeletal manifestations in inflammatory bowel disease patients.Sacroiliitis radiological evidence is frequently present but not always necessary. However, the initiation of spinal disease frequently occurs before the diagnosis of inflammatory bowel disease. Articular symptoms might start concurrently with or after bowel disease.

The prevalence of the various musculoskeletal symptoms is comparable in Crohn’s disease and ulcerative colitis. After proctocolectomy, symptoms typically go away. Uncertain pathogenetic pathways underlie the inflammatory bowel disease’s musculoskeletal symptoms. There are numerous arguments in favour of the intestinal mucosa playing a significant role in the onset of spondylarthropathy. The natural history of the condition is marked by flare-ups and remissions, making it challenging to determine the effectiveness of treatment. The majority of patients improve with rest, physical therapy, and no steroidal anti-inflammatory medications, however these medications may exacerbate gastrointestinal problems. Some patients may benefit from taking Sulphasalazine. The use of steroids systemically has not been proven. The majority of errors occurred in situations where clinical and radiological features were ineffective at supporting or invalidating the diagnosis. The frequency of mistakes increased over time, maybe as a result of the pathologist’s health deteriorating. In previously published studies, the percentage of incorrect diagnoses for bone tumours ranged from 9 to 40%. Multidisciplinary collaboration and routine audit are crucial for ensuring the highest rate of diagnosis accuracy achievable.