Epidemiology of Musculoskeletal Manifestations in Pediatric Inflammatory Bowel Disease: A Systematic Review

Abstract

Objective Pediatric inflammatory bowel disease (p‐IBD) is a chronic relapsing gastrointestinal disorder of childhood with long‐term morbidity. Several extraintestinal manifestations are described, the most common being joint pain and/or inflammation. However, patient and disease characteristics, treatments, and outcomes of p‐IBD‐associated musculoskeletal disease are not well established. Our study aims to summarize the recent literature on the epidemiology of musculoskeletal manifestations in p‐IBD in the era of biologics. Methods A systematic search of PubMed, Embase, Cochrane Library, Web of Science Core Collection, and Cumulative Index to Nursing and Allied Health Literature databases was performed with relevant keywords. Studies in English published from January 1, 2000, to December 21, 2020, were included. In total, 3893 articles were identified and screened. Study and population characteristics and outcomes of interest were recorded. Risk of bias assessment was performed using the Joanna Briggs Institute Critical Appraisal Tools. Results Thirteen studies were included for full review, which were primarily single‐center observational studies with retrospective or cross‐sectional designs. The diagnostic criteria and definitions used for musculoskeletal manifestations varied. Musculoskeletal manifestation prevalence ranged from 2% to 35%. Only one study assessed the response of musculoskeletal manifestations to biologics. Risk of bias demonstrated heterogeneity in study quality. Conclusion This is the first systematic review of musculoskeletal manifestations in p‐IBD. Analysis was limited because of variability in study design and data‐reporting methods. Definitions varied among included studies, with a clear lack in standardization. Our study demonstrates the need for standardized assessment of musculoskeletal manifestations of p‐IBD and further research to explore optimal management to advance care for this group of children.

The Prevalence of extraintestinal manifestations in Inflammatory Bowel Disease

“…Improving the MSU procedure by the addition of B-mode power Doppler or contrast-enhanced ultrasonography enhances the diagnostic precision of MSU for the evaluation of enthesitis, thereby becoming a highly specific diagnostic method. (17)(18) There are two different forms of peripheral arthritis that have been reported in relation to IBD. Peripheral arthritis type 1, an asymmetrical oligoarthritic, is more frequent and is typically related to attacks of IBD.…”

Extraintestinal manifestations in infl ammatory bowel diseases in children, a modern view of the problem

“…Изменение анатомической структуры тонкой и толстой кишки вследствие активного воспаления, хирургических вмешательств могут привести к развитию синдрома мальабсорбции, дефициту белка, витаминов, минералов, солей желчных кислот. Помимо этого, часто применяемые препараты для лечения пациентов с воспалительными заболеваниями кишечника, в свою очередь могут быть связаны со многими кишечными и внекишечными побочными эффектами, определяя некий порочный круг [32,[33][34][35][36][37].…”

“…При ВЗК возможны поражения любых органов (табл. 2), но наиболее часто поражаемые «органымишени» -суставы, кожа и слизистые оболочки, глаза и гепатобилиарная система [5,[33][34][35][36][37].…”