Crohn's disease arthritis mainly occurs in young and middle-aged adults, with15～35years old is more common, and the elderly are mainly affected by the colon, with ileocecal lesions accounting for5of patients have involvement limited to the colon10of patients have both the colon and small intestine involved3above, and the onset is usually gradual. Specific symptoms are as follows:
Section 1: Digestive System
Abdominal pain is the most common symptom, with pain often located around the umbilicus and the lower right abdomen, presenting as mild colic or discomfort before defecation, which can be relieved after defecation. Diarrhea is generally3～6due to impaired absorption of bile acids, water, and fats, the feces are semi-liquid. When the lesion involves the colon, fecal incontinence can occur, with symptoms of urgent need to defecate. In the later stage of the disease, palpable masses can be felt.
Section 2: Skin
Nodular erythema is a common skin lesion of this disease, usually parallel to the activity of the disease, mainly distributed on the extensor side of the lower limbs, and some can form ulcers.
Erysipelas is a deep, necrotic ulcerative skin injury, with marked pain, often located in the anterior compartment of the tibia in the lower limbs, often accompanied by systemic symptoms. The lesions are solitary, but can also be multiple or extensive. If not treated, the lesions can progress to the deep tissue and cause osteomyelitis. Other skin lesions include eczema, maculopapular rash, erythema, urticaria, and polymorphic erythema, etc.
Section 3: Arthritis
1, Peripheral arthritis:There are10% to2of Crohn's disease patients develop peripheral arthritis, which is the most common extraintestinal manifestation of Crohn's disease, and is mainly seen in patients with colonic involvement. The involved joints are similar to those in ulcerative colitis, presenting as subacute, asymmetric oligoarthritis, most commonly affecting the knee joints, followed by ankle joints, and then shoulder, wrist, elbow, metacarpophalangeal joints, large joints are more susceptible than small joints, and lower limb joints are more susceptible than upper limb joints. Arthritis usually does not leave deformity, but can cause joint pain, tenderness, and sometimes joint effusion. Joint symptoms generally last for several weeks or even more than a month.
2, Spondylitis:1% to25% of patients can develop ankylosing spondylitis, and it is determined to be about5% of patients have no significant sacroiliac joint symptoms, and the number of sacroiliitis detected by radiological examination of the sacroiliac joints is more than that of symptomatic sacroiliitis.3times, spondylitis can occur before, after, or simultaneously with intestinal lesions, and is not parallel to the activity of intestinal lesions. Controlling the symptoms of spondylitis will not alleviate the symptoms of intestinal disease. Some patients may develop acrocyosis, which is more common in those with upper small intestinal involvement. Those with acrocyosis also have a higher incidence of internal fistulas and malabsorption.
Section 4: Urogenital System
The urinary tract stones are a common complication of Crohn's disease, more common in those who have undergone colon resection and ileostomy, which may be due to severe diarrhea or ileostomy causing a large loss of secretions, urine concentration, leading to a decrease in urine pH and the formation of uric acid stones. Impaired absorption of bile salts also causes excessive absorption of oxalates in the small intestine, which is also a cause of urinary tract stones. In addition, obstructive pyelonephritis, perinephric abscess, renal amyloidosis, and the formation of enteric fistulas can also lead to urinary tract lesions and cause urinary tract stones.
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