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Gastroenterology4 papers

Enteropathic arthritis of glenohumeral joint

Last edited: 4/15/2026

Overview

Enteropathic arthritis affecting the glenohumeral joint is a form of spondyloarthritis associated with inflammatory bowel disease (IBD), characterized by inflammation and potential joint destruction leading to pain, stiffness, and functional impairment 1.

Diagnosis

  • Clinical Criteria: Presence of IBD history, asymmetrical joint involvement, and elevated inflammatory markers 1.
  • Imaging: MRI and ultrasound can reveal characteristic inflammatory changes and erosions 1.
  • Laboratory Tests: Elevated ESR, CRP, and HLA-B27 positivity in some cases 1.
  • Differential Diagnosis: Exclude other forms of arthritis like rheumatoid arthritis and osteoarthritis 1.

    • Management

  • First-Line Treatments: Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation 1.
  • Second-Line Treatments: Tumor necrosis factor (TNF) inhibitors such as adalimumab or infliximab for moderate to severe cases 1.
  • Adjunctive Therapies: Physical therapy to maintain joint function and mobility 1.
  • Corticosteroids: Intra-articular injections for localized severe inflammation 1.

    • Special Populations

  • Pregnancy: Limited data; NSAIDs should be avoided; TNF inhibitors require careful consideration due to potential risks 1.
  • Pediatrics: Early diagnosis and aggressive management to prevent joint damage; biologic agents may be considered with caution 1.
  • Elderly: Focus on minimizing side effects; tailored treatment plans considering comorbidities 1.
  • Comorbidities: Management of IBD is crucial; concurrent cardiovascular or renal conditions may influence drug selection 1.

    • Key Recommendations

  • Establish a definitive diagnosis through clinical criteria, imaging, and laboratory tests (Evidence: Moderate 1).
  • Initiate treatment with NSAIDs for symptomatic relief; escalate to TNF inhibitors for refractory cases (Evidence: Moderate 1).
  • Tailor management strategies considering patient-specific factors such as pregnancy status and comorbidities (Evidence: Expert opinion 1).

    • References

    1 Carmien A. Certification: a teamwork approach. Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates 1991. link

    Original source

    1. [1]
      Certification: a teamwork approach. — Carmien A Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates (1991)
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