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Enteropathic Arthritis Overview and Facts

When it comes to anterior or posterior hip replacement, people with certain types of arthritis might require this type of surgery at some point. Enteropathic arthritis is a type of arthritis that affects the joints and the spine that commonly occurs in conditions such as Crohn’s disease, inflammatory bowel disease, and ulcerative colitis. This type of arthritis is classified as a spondylarthropathy. Other spondylarthropathies include psoriatic arthritis, reactive arthritis and spondylitis.


When looking at patients with inflammatory bowel disease, about 20 percent develop arthritis. The incidence is higher in patients with Crohn’s disease.

Signs and Symptoms

This type of arthritis may present as peripheral arthritis, axial arthritis, or mixed. As peripheral arthritis, the pattern is usually asymmetric and affecting four or fewer joints. As axial arthritis, the symptoms are usually stiffness and pain in the back that are similar to ankylosing spondylitis. Gastrointestinal symptoms are also common.

Making the Diagnosis

The patient’s doctor will usually start by thoroughly discussing the signs and symptoms the patient is experiencing and then performing a physical examination. The doctor will then often look for signs of anemia and perform a blood test to check the patient’s iron levels. Other blood tests may include an ESR and a CRP because when elevated they indicate inflammation.

X-rays are commonly done. The doctor will be looking at the peripheral joints for a lack of erosive changes. He or she will then examine the spinal and sacroiliac joints for a resemblance to ankylosing spondylitis. If there is inflammation present in the sacroiliac joint, this is suggestive of enteropathic arthritis.

Stool testing may be performed, particularly, if the patient is experiencing gastrointestinal symptoms, such as diarrhea and abdominal pain, but has not been diagnosed with any inflammatory bowel conditions. The patient’s stool will be examined for infections and blood.

A colonoscopy may be performed to get a more detailed look at the patient’s digestive tract. This is most often done when the patient is having gastrointestinal symptoms.

Getting a sample of synovial fluid might be done for patients who have painful joints. This involves using a needle to get a sample of the fluid. This is done to rule out, infection, gout and other possible causes of inflammation.

Treatment Options

This type of arthritis is treated in a similar fashion as other spondylarthropathies for joint symptoms. Both the bowel disease and the arthritis have to be treated. Non-steroidal anti-inflammatory drugs often effectively treat the arthritis, but these types of drugs will typically worsen the bowel disease. There is a certain class of medications, known as anti-TNF drugs, that are successful for most patients in treating both the arthritis and the bowel disease. Commonly prescribed medications for enteropathic arthritis are anti-TNF drugs include Humira, Remicade and Cimzia.

You can see that this type of arthritis can certainly be complex. In cases where joints are severely impacted, your doctor might discuss more intense treatments with you, such as anterior or posterior hip replacement.

If you would like to request a consultation with one of the orthopedic specialists at the Orthopedic & Sports Institute (OSI), please call (920) 560-1000 or request an appointment online. Additionally, OSI now offers a Walk-In Clinic at its Appleton location for non-life threatening situations that require immediate attention.

The Orthopedic & Sports Institute has convenient locations to serve you. In addition to the flagship facility in Appleton, you will find outreach clinics in New London, Ripon, Shawano, Waupaca, and the newest location serving the Green Bay area, inside the NOVO Health Clinic in De Pere.

OSI is a proud member of NOVO Health.