Manifestations articulaires des affections intestinales

Inflammatory enterocolonopathies or intestine chronic inflammatory diseases refer to both Crohn's disease and haemorrhagic rectocolitis. They are part of the spondylarthropathies group. Osteoarticular lesions occur in 1/3 of affected patients; they are the most frequent extra-digestive manifestations of these diseases and may reveal the intestinal affection. The frequency of osteopenia and osteoporosis imposes early detection and adapted management. Arthralgias or non destructive asymmetric pauciarticular arthritis often occur together with enterocolonopathy-induced digestive crises. Frequently, they are associated with other extra-intestinal manifestations. Sacro-iliitis may occur as an isolated event. About 6% of patients with an intestine chronic inflammatory disease have also a real spondylarthropathy as defined by Amor's criteria or the European criteria. The clinical manifestations occur independently from the digestive crises. When managing a spondylarthropathy, systematic screening for inflammatory enterocolonopathy should be undertaken. Whipple's disease is a curable chronic bacterial infection with a multisystemic pattern, due to Tropheryma whipplei. It generally begins with a recurrent joint lesion in a middle-aged man, followed some years later by emaciation and diarrhoea diversely associated with other clinical manifestations. Arthralgia, and even real polyarthritis and tenosynovitis may be encountered when managing intestinal bypass, celiac disease, and microscopic colitis.