Articular Manifestations in Inflammatory Bowel Disease: A Retrospective Study From a Moroccan Tertiary Care Center

Background: Articular manifestations are among the most common extraintestinal manifestations of inflammatory bowel disease (IBD) and may precede, accompany, or follow intestinal symptoms. Their recognition is clinically important because delayed diagnosis can lead to functional impairment and structural damage. Methods: We conducted a retrospective descriptive study in the Department of Hepato-Gastroenterology at Mohammed VI University Hospital, Marrakech, Morocco. Patients with confirmed IBD and associated rheumatologic manifestations who were followed between December 2023 and December 2024 were included. Epidemiological, clinical, biological, radiological, therapeutic, and outcome data were extracted from medical records and analyzed using Microsoft Excel 2019 (Microsoft Corporation, Redmond, USA). Results: Among 150 patients with IBD, 60 had articular manifestations, corresponding to a prevalence of 40%. Crohn disease (CD) was present in 33 patients (55%), ulcerative colitis (UC) in 24 patients (40%), and indeterminate colitis in three patients (5%). There was a female predominance, with 41 women (68.3%) and 19 men (31.7%). Articular symptoms occurred after the diagnosis of intestinal disease in 37 patients (61.7%), before it in 17 patients (28.3%), and concomitantly in six patients (10%). Mixed axial and peripheral involvement was the most frequent pattern, observed in 35 patients (58.3%), followed by isolated peripheral involvement in 16 patients (26.7%) and isolated axial involvement in nine patients (15%). Inflammatory back pain was reported in 44 patients (73.3%), buttock pain in 37 patients (61.7%), and radiographic sacroiliitis in 25 patients (41.7%). Human leukocyte antigen B27 (HLA-B27) was positive in three of 33 tested patients (9.1%). Conclusions: Articular manifestations were frequent in this Moroccan IBD cohort and were dominated by mixed axial and peripheral involvement. Systematic screening for musculoskeletal symptoms in patients with IBD and close collaboration between gastroenterologists and rheumatologists are essential for early diagnosis, optimized management, and prevention of functional impairment.