Sacroliliitis as Debut of Crohn’s Disease

Aim: to present a clinical case of a patient with sacroiliitis preceding the development of the typical clinical picture of Crohn’s disease with colonic involvement. Key points. Patient K., 39 years old, was admitted to the clinic with complaints of pain in the sacral area lasting for 13 years, which was later joined by pain in the left iliac region, unstable stool (alternating diarrhea and constipation), hematochezia. Examination revealed signs of Crohn’s disease with colonic involvement and bilateral sacroiliitis. Therapy with adalimumab was initiated with a good clinical effect. Follow-up examination achieved endoscopic remission of the disease; however, residual MRI signs of bilateral sacroiliitis persist. Conclusion. This clinical case describes the outcome of adalimumab therapy in a patient with colonic Crohn’s disease, whose initial manifestation was the development of sacroiliitis. Adalimumab is well-established as an effective treatment for both Crohn’s disease and sacroiliitis, including when they occur concomitantly.