Background/Purpose: Inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, is a systemic chronic inflammatory disease of the gastrointestinal tract where extraintestinal manifestations (EIMs) are common. The musculoskeletal system is the most common EIM with spondyloarthropathies (SpA) seen in up to 39% of patients with IBD. Despite its prevalence, there remain challenges in early identification of SpA in patients with IBD. The aim of this scoping review was to identify and describe the validity of screening tools for IBD-related arthritis.

Methods: We searched MEDLINE and Embase (inception to August 15, 2025) to identify studies of screening tools used to detect SpA in both pediatric and adult IBD patient populations. Review articles, opinion-based articles, conference abstracts, incomplete publications and non-English studies were excluded. Screening of studies for eligibility was performed on Covidence, with conflicts resolved by consensus amongst three reviewers. Data was extracted and synthesized.

Results: Of 568 studies identified, 14 studies were included. All identified studies reported on adults with IBD. Six studies reported on the validation of SpA screening tools, including DETAIL (n=3), IBIS-Q (n=2), and structured clinical screening criteria used in individual studies. Validation studies demonstrated that screening tools such as DETAIL and IBIS-Q showed moderate–high sensitivity ranged 43–92.7% and specificity 62–89.8%, with ≥3 positive items consistently corresponding to a high post-test probability of SpA ranging from 75.0–81.9%. These same scales, along with diagnostic imaging, were used to determine the prevalence of SpA among people with IBD. The prevalence of SpA or sacroiliitis among adults with IBD ranged from approximately 5–30%, with many cases previously unrecognized in routine care. All included studies were conducted in academic or tertiary referral centres.

Conclusion: DETAIL and IBIS-Q are validated tools that can be used for early detection and referral of SpA among adults living with IBD. Study design evaluating the prevalence of SpA using these tools were heterogenous, leading to varied prevalence estimates. All included studies were from referral centres where patients often have more complex IBD presentations which may influence prevalence estimates and limit generalizability to community practice.
Coordinated efforts between gastroenterology and rheumatology, will be critical to refine, validate, and implement IBD-appropriate tools that support integrated, patient-centered care. This is critical in the pediatric population where there is a complete absence of screening tools.
 

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/screening-tools-for-spondyloarthropathies-among-patients-with-inflammatory-bowel-disease-a-scoping-review/