Background: Musculoskeletal (MSK) symptoms are the most common extra-articular manifestations of pediatric-onset inflammatory bowel diseases (pIBD), and are associated with a more aggressive disease course. This study aims to characterize MSK manifestations in patients with pIBD, and to seek for predictors of persistently active arthritis one year after pIBD diagnosis. Methods: A multicenter, retrospective cohort study was conducted at 25 Italian pediatric rheumatology centers. Patients aged < 18 years with pIBD and MSK manifestations, followed for at least one year, were included. Data at onset of first MSK symptom, pIBD diagnosis, and one-year follow-up visit following pIBD diagnosis were collected. Results: A total of 180 patients were included, 111 (61.7%) with Crohn’s disease (CD), 55 (30.5%) with ulcerative colitis (UC), and 14 (7.8%) with unclassified IBD (IBDU). Arthralgia (72.8%) and arthritis (69.4%), were the most frequent MSK manifestations. Patients with CD had MSK symptoms prior to pIBD diagnosis more frequently than those with UC/IBDU (51.4% vs. 40.6%). Among the 125 patients with arthritis, 76.8% had peripheral arthritis, 14.4% had axial disease, and 8.8% had both peripheral and axial involvement. The most common articular pattern was oligoarthritis (52.0%), followed by monoarthritis (26.4%) and polyarthritis (21.6%). The most frequently affected joints were the knee, ankle, and hip. On multivariable analysis, antinuclear antibody (ANA) positivity (OR = 3.05, 95% CI: 1.05 – 8.89) and a polyarticular course of arthritis (OR = 3.42, 95% CI: 1.13–10.38) were independently associated with persistence of active arthritis at year 1 after pIBD diagnosis. Conclusions: Most patients with pIBD and arthritis presented with peripheral oligoarthritis affecting lower limb joints. A positive ANA status and development of polyarthritis predicted sustained arthritis activity. Supplementary information: The online version contains supplementary material available at 10.1186/s12969-025-01141-z.
Musculoskeletal manifestations in children with inflammatory bowel disease: a multicenter cohort study (GASTROREUM study) / Civino, Adele; Diomeda, Federico; Gallizzi, Romina; Gattorno, Marco; Magni-Manzoni, Silvia; Montin, Davide; Simonini, Gabriele; Conti, Giovanni; Del Giudice, Emanuela; Filocamo, Giovanni; Civitelli, Fortunata; Miniaci, Angela; Pastore, Serena; La Torre, Francesco; Lattanzi, Bianca; Mauro, Angela; Mambelli, Lorenzo; Barone, Patrizia; Olivieri, Alma Nunzia; Vergine, Gianluca; Maggio, Maria Cristina; Floretta, Ilenia; Campus, Simona; Cantarini, Luca; Sacco, Emanuela; Cappella, Michela; Arrigo, Serena; Tarantino, Giusyda; Taurisano, Manuela; Greco, Silvia; Greco, Rossella; De Benedetti, Fabrizio; Bovis, Francesca; Ravelli, Angelo. - In: PEDIATRIC RHEUMATOLOGY ONLINE JOURNAL. - ISSN 1546-0096. - 23:1(2025). [10.1186/s12969-025-01141-z]
Musculoskeletal manifestations in children with inflammatory bowel disease: a multicenter cohort study (GASTROREUM study)
Del Giudice, Emanuela;Civitelli, Fortunata;
2025
Abstract
Background: Musculoskeletal (MSK) symptoms are the most common extra-articular manifestations of pediatric-onset inflammatory bowel diseases (pIBD), and are associated with a more aggressive disease course. This study aims to characterize MSK manifestations in patients with pIBD, and to seek for predictors of persistently active arthritis one year after pIBD diagnosis. Methods: A multicenter, retrospective cohort study was conducted at 25 Italian pediatric rheumatology centers. Patients aged < 18 years with pIBD and MSK manifestations, followed for at least one year, were included. Data at onset of first MSK symptom, pIBD diagnosis, and one-year follow-up visit following pIBD diagnosis were collected. Results: A total of 180 patients were included, 111 (61.7%) with Crohn’s disease (CD), 55 (30.5%) with ulcerative colitis (UC), and 14 (7.8%) with unclassified IBD (IBDU). Arthralgia (72.8%) and arthritis (69.4%), were the most frequent MSK manifestations. Patients with CD had MSK symptoms prior to pIBD diagnosis more frequently than those with UC/IBDU (51.4% vs. 40.6%). Among the 125 patients with arthritis, 76.8% had peripheral arthritis, 14.4% had axial disease, and 8.8% had both peripheral and axial involvement. The most common articular pattern was oligoarthritis (52.0%), followed by monoarthritis (26.4%) and polyarthritis (21.6%). The most frequently affected joints were the knee, ankle, and hip. On multivariable analysis, antinuclear antibody (ANA) positivity (OR = 3.05, 95% CI: 1.05 – 8.89) and a polyarticular course of arthritis (OR = 3.42, 95% CI: 1.13–10.38) were independently associated with persistence of active arthritis at year 1 after pIBD diagnosis. Conclusions: Most patients with pIBD and arthritis presented with peripheral oligoarthritis affecting lower limb joints. A positive ANA status and development of polyarthritis predicted sustained arthritis activity. Supplementary information: The online version contains supplementary material available at 10.1186/s12969-025-01141-z.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
