Granulomatous Synovitis and Crohn's Disease

To the Editor: Nugent and his coauthors (N Engl J Med 294:262, 1976) have called attention to granulomatous bone lesions accompanying Crohn's disease. The peripheral arthropathy of inflammatory bowel disease has usually been characterized as a benign nonspecific polyarthralgia and synovitis that rarely leads to joint or bone destruction. We have seen two patients, a 22-year-old woman and a 14-year-old boy, with progressive monarticular arthritis with radiologic evidence of altered articular cartilage and subchondrial bone. One had joint narrowing of the hip; the other demonstrated subchondrial erosion of the lateral condyle of the knee. A synovial biopsy in the. . . No extract is available for articles shorter than 400 words.