{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T15:39:07Z","timestamp":1781278747137,"version":"3.54.1"},"reference-count":59,"publisher":"Oxford University Press (OUP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,5,1]]},"abstract":"\n Background and Purpose<\/jats:title>\n Patients with inflammatory spinal conditions related to spondyloarthritis are rarely seen by primary care practitioners. However, patients with a history of inflammatory bowel disease and chronic low back or buttock pain should be examined carefully for the presence of spondyloarthritis, as proper management may include referral to a rheumatologist and appropriate medical intervention.<\/jats:p>\n <\/jats:sec>\n \n Case Description<\/jats:title>\n A 27-year-old woman with a 6-month history of posterior buttock pain was referred for physical therapy with a diagnosis of piriformis syndrome. During the second physical therapy visit, a nonmechanical source of lumbopelvic pain was suspected, and the patient was referred for medical consultation. The patient underwent evaluation by a rheumatologist and was eventually diagnosed with spondyloarthritis associated with inflammatory bowel disease.<\/jats:p>\n <\/jats:sec>\n \n Outcomes<\/jats:title>\n The patient initiated treatment with anti-tumor necrosis factor medication to address the spondyloarthritis. Medical management resulted in significant improvement in all outcome measures.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n Clinical suspicion of spondyloarthritis is raised when specific historical, examination, and imaging findings are present. The posttest probability of spondyloarthritis is increased with the presence of inflammatory back pain and specific spondyloarthritic features, such as a positive history of inflammatory bowel disease, radiographic evidence of sacroiliitis, and improvement with anti-inflammatory medication. Referral of patients with these findings for a rheumatological evaluation is warranted, as these diseases are managed effectively with specific treatment.<\/jats:p>\n <\/jats:sec>","DOI":"10.2522\/ptj.20090172","type":"journal-article","created":{"date-parts":[[2010,3,19]],"date-time":"2010-03-19T00:34:56Z","timestamp":1268958896000},"page":"784-792","source":"Crossref","is-referenced-by-count":7,"title":["Spondyloarthritis in a Patient With Unilateral Buttock Pain and History of Crohn Disease"],"prefix":"10.1093","volume":"90","author":[{"given":"Rogelio A.","family":"Coronado","sequence":"first","affiliation":[{"name":"R.A. Coronado, PT, CSCS, FAAOMPT, is a doctoral student in the Department of Physical Therapy, College of Public Health and Health Professions, University of Florida, PO Box 100154, Gainesville, FL 32610-0154 (USA). At the time of this case, Mr Coronado was enrolled in the Manual Therapy Fellowship Program at Duke University."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles Z.","family":"Sheets","sequence":"additional","affiliation":[{"name":"C.Z. Sheets, PT, OCS, Dip MDT, is Staff Physical Therapist, Duke University Medical Center, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chad E.","family":"Cook","sequence":"additional","affiliation":[{"name":"C.E. Cook, PT, PhD, MBA, OCS, FAAOMPT, is Associate Professor, Division of Physical Therapy, Department of Community and Family Medicine, Duke University."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William G.","family":"Boissonnault","sequence":"additional","affiliation":[{"name":"W.G. Boissonnault, PT, DHSc, FAAOMPT, is Associate Professor, Division of Physical Therapy, Department of Orthopedics and Rehabilitation, University of Wisconsin\u2013Madison, Madison, Wisconsin."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","reference":[{"key":"2019123105475726100_B1","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1001\/jama.1992.03490060092030","article-title":"What can the history and physical examination tell us about low back pain?","volume":"268","author":"Deyo","year":"1992","journal-title":"JAMA"},{"key":"2019123105475726100_B2","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1097\/00007632-199702150-00015","article-title":"Spinal radiographic findings and nonspecific low back pain. 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