{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T07:25:42Z","timestamp":1767165942367,"version":"build-2238731810"},"reference-count":56,"publisher":"Wiley","issue":"11-12","license":[{"start":{"date-parts":[[2019,10,25]],"date-time":"2019-10-25T00:00:00Z","timestamp":1571961600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"AbbVie Belgium"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Spondyloarthritis is the most frequent extra\u2010intestinal manifestation of IBD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To present simple strategies to identify and differentiate inflammatory joint pain in IBD patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A panel of Belgian gastroenterologists and rheumatologists developed seven algorithms for IBD patients with joint symptoms based on a Delphi exercise conducted between April and December 2016. Here, we focus on referral strategies for patients with chronic back pain (evidence\u2010based strategy), large joint monoarthritis, oligo\u2010 or polyarticular arthritis or arthralgia (based on expert opinion). We also present management tools for IBD patients with acute back pain and small joint monoarthritis\u00a0(Supplementary file).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The reported algorithm for IBD patients with chronic back pain uses basic clinical criteria to identify which patients should be referred to the\u00a0emergency room (spondylodiscitis), physical medicine\u00a0and rehabilitation (mechanical back pain) or rheumatologist (spondyloarthritis). IBD patients with large joint monoarthritis should be referred to emergency room if septic arthritis is suspected; in other patients, blood analyses and referral to a rheumatologist for articular puncture with evacuation of synovial fluid are recommended. The analysis of synovial fluid allows for identification of non\u2010inflammatory (e.g., osteoarthritis) and inflammatory (e.g., [pseudo]\u2010gout, peripheral spondyloarthritis and\n                      <jats:italic>Borrelia burgdorferi<\/jats:italic>\n                      arthritis) conditions. In patients with inflammatory oligoarticular or polyarticular arthralgia, erythrocyte sedimentation rate, concomitant therapies, anti\u2010nuclear factor and anti\u2010double\u2010stranded DNA antibody levels should be evaluated; in anti\u2010tumour necrosis factor\u2010treated patients, a drug\u2010induced lupus\u2010like syndrome should be considered.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We propose straightforward strategies for IBD patients with joint symptoms, which are specific enough to select initial treatment and referral pattern.<\/jats:p>\n                  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