Crohn’s Disease Presenting with Acute Monoarthritis: A Case Report

Inflammatory bowel disease (IBD) is a systemic disease and is accompanied by extraintestinal findings in up to 50% of cases. Extraintestinal findings occur before the diagnosis of IBD in only 6% of cases. Findings aren’t always related to the degree of inflammation in the intestine and can be seen without intestinal symptoms. Musculoskeletal pathologies are seen in 6-46%; arthritis is more common in Crohn's patients with colonic involvement than ulcerative colitis; it can be classified as type 1 arthropathy, which is usually acute, asymmetric, and frequently involves a single large joint such as the knee joint, and type 2 arthropathy, which is symmetric and involves multiple small joints such as the metacarpophalangeal joints. Type 1 arthropathy develops in most cases of IBD accompanied by arthritis, and the rate is only about 5%. Joint findings are mostly related to IBD activity, usually self-limiting for up to 10 weeks, and may rarely occur before intestinal symptoms. In this case report, a 23-year-old male patient with acute monoarthritis as the first symptom and diagnosed with Crohn's disease is presented, emphasizing that it should be kept in mind that conditions such as peripheral arthritis of unknown cause may be an extraintestinal symptom of IBD.