What question did this study set out to answer?

This study aims to assess how collaboration between gastroenterologists and rheumatologists impacts the early diagnosis of inflammatory bowel disease-related spondyloarthritis.

May 16, 2026Open Access

The role of a multidisciplinary approach in the early and differential diagnosis of inflammatory bowel disease–related spondyloarthritis: insights from a cross-sectional study

Key Points

This study aims to assess how collaboration between gastroenterologists and rheumatologists impacts the early diagnosis of inflammatory bowel disease-related spondyloarthritis.
Consecutive IBD outpatients were evaluated in joint consultations between rheumatologists and gastroenterologists.
Patients completed the DETAIL screening questionnaire, and further assessments included laboratory and imaging investigations.
Cases were categorized as new IBD-SpA, alternative diagnoses, or non-specific arthralgias.
117 suspected IBD-SpA cases were identified, with 18 confirmed diagnoses, leading to a 22% increase in overall SpA cases.
Patients with axial involvement had longer diagnostic delays, averaging 12.4 years.
The swollen joint count was a significant predictor for new IBD-SpA diagnoses (adjOR 5.70, p < 0.001).

Abstract

Objectives Inflammatory bowel disease-related spondyloarthritis (IBD-SpA) commonly complicates IBD. Early diagnosis is essential; however, it is often delayed due to clinical heterogeneity and the lack of specific diagnostic criteria. This study aimed to evaluate the outcomes of close collaboration between gastroenterologists and rheumatologists in the classification of the musculoskeletal (MSK) manifestations in IBD patients, focusing on the early diagnosis of IBD-SpA and its differentiation from other conditions. Methods Consecutive IBD outpatients underwent a comprehensive rheumatologic evaluation during a joint rheumatologist–gastroenterologist consultation, including the DETection of Arthritis in Inflammatory boweL diseases (DETAIL) screening questionnaire, and, when appropriate, laboratory and imaging investigations. Suspected IBD-SpA cases were classified as newly diagnosed IBD-SpA, having an alternative arthropathy diagnosis, or having non-specific arthralgias, and their characteristics were analyzed. Results A total of 605 IBD patients were evaluated. At the first assessment, 81 patients had a pre-existing diagnosis of SpA and 117 patients of suspected IBD-SpA cases were identified. Among the latter assessment, 18 (15%) were confirmed as new IBD-SpA diagnoses, resulting in a 22% relative increase in the total number of SpA cases and raising the overall prevalence from 13.4 to 16.4%. Patients with axial involvement experienced a longer diagnostic delay (mean 12.4 vs. 2.9 years, p = 0.035). Of the new IBD-SpA diagnoses, 72% resulted in treatment modifications jointly decided by the gastroenterologist and rheumatologist. However, 85% of suspected IBD-SpA cases were ultimately excluded, with 60% classified as other arthropathies (primary osteoarthritis and fibromyalgia) and 25% as non-specific arthralgias. The swollen joint count was the only significant predictor of a new IBD-SpA diagnosis (adjOR 5.70, p 0.001), with a trend toward significance for fecal calprotectin levels ≥200 μg/g (adjOR 2.88, p = 0.070). Conclusion The multidisciplinary approach enables early and accurate diagnosis of IBD-SpA, minimizing the risk of misclassification of musculoskeletal manifestations and unwarranted treatment changes.

Mark Helpful

Bookmark

Relay

View Full Paper