IBD related arthritis

• Two perianal abscess

• Buttok pain worse on sitting

• Neck pain

• Loss stool

• Both wrist pain Rt knee pain

• 64 years old man known with crohn`s disease.

• Develop recurrent painful swelling of both knees.

• His knees were aspirated and injected twice without benefit

• Steroid therapy

• SSZ – abnormal LFT

• AZT – dose increased up to 75mg bd

• Patient felt better