Morning Report 11/10: IBD-Associated Arthritis

Today we had one of our amazing PGY3s and future gastroenterologists present a case on IBD-Associated Arthritis. The case started with a women transferred from an outside hospital for migratory polyarthritis and rash. We had Dr Chelsea Smith from our Rheumatology Department to walk show us her approach to polyarthritis. As a team, we used the patient demographics, history and rash to work through the different categories of seronegative arthritis and diagnose the patient with IBD-Associated Seronegative Arthritis!

Teaching Points

Polyarthritis can be broken down into seropositive (positive RF and CCP ab) or seronegative arthritis.

Seronegative Arthritis includes seronegative rheumatoid arthritis, infectious arthritis, systemic rheumatoid disease, crystal arthropathy, and spondyloarthropathy. History and physical exam will help with differentiating between different types of seronegative arthritis.

IBD is associated with various extra-intestinal manifestations including arthritis and dermatologic conditions, as seen in this patient.

Erythema nodosum and pyoderma gangrenosum are the most common cutaneous manifestations of IBD, however other manifestations include Sweet Syndrome and cutaneous vasculitis (like our patient had)!

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