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Major joint pain but not flaring.

I’ve had Crohns for almost 20yrs now (I’m 57). Have never had joint issues til 2018, been on Mtx maintenance dose for Crohns for years. Joint Pain has been out of control all year. Seeing a Rheumy now for arthritis pain. Did a 3 month round of steroids to get under control. Was great. Pain subsided within 24 hrs. Now off steroids (up 14 lb!). Trying Leflunomide w Mtx with no relief.
Anyone else had such bad arthritis w no gut activity? Rheumy says likely now have RA or Psoriatic Arthritis as well as Fibromyalgia. So maybe that explains the fact that Crohns symptoms are fine?

my little penguin

Staff member
Ds has juvenile SpondyloArthritis which is quite common with Crohns
His arthritis can flare independently of his Crohns .
Right now his arthritis causes more grief than Crohns

He currently takes Stelara and mtx to control both
Good luck at the Rheumo


Staff member
There are different kinds of arthritis associated with IBD - spondyloarthritis (SpA) is most commonly associated with it. Have they tested you for HLA B27?

RA is less common than SpA with IBD. For RA, did the rheumatologist check your Rheumatoid Factor and anti-CCP antibodies? If they were negative, I would guess it's some type of SpA.

Psoriatic arthritis is a type of SpA as is Ankylosing Spondylitis. Some types of arthritis flare when the IBD flares and some do not. Typically, if the spine is involved, the spondyloarthritis flares independently from the Crohn's. This is called axial spondyloarthritis.

If the spine isn't involved, it's usually considered peripheral spondyloarthritis or psoriatic arthritis. Peripheral joint involvement typically flares up when the IBD flares. The exception is the small joints in the hands - those typically flare independently from the IBD. Large joints, like knees or hips or ankles, tend to flare when the IBD is flaring.

This explains it better: http://www.crohnscolitisfoundation.org/assets/pdfs/arthritiscomplications.pdf

As for treatment, it sounds like you need a biologic if you have failed MTX and Arava (Leflunomide). Humira or Remicade would work for both the arthritis and the IBD. Cimzia and Stelara would also work, but they're typically not used as the first biologic.
Hi. I've spent the last year seeing a rheumatologist trying to find the cause of my joint issues. I have a whole range of aches and pains which move about from joint to joint and vary from mildly annoying to sleep-wrecking agony. This is alongside other new skin reactions and random blood results. Meanwhile, my gut seems to be the only thing that is behaving itself (thankfully)!

There doesn't seem to be any consensus as to whether these are EMIs of Crohn's or whether I am just collecting new immune-related conditions.