Ulcerative colitis with lead pipe appearance and arthropathy

Case contributed by Andrew Dixon
Diagnosis certain


Abdominal pain and diarrhea for 3 weeks. Past history of inflammatory arthritis.

Patient Data

Age: 45 years
Gender: Male

Featureless transverse colon and distal descending colon / proximal sigmoid consistent with the lead pipe sign of chronic ulcerative colitis. Additional chronic sacroiliitis with ankylosis on the left and partial ankylosis on the right. Asymmetric left hip joint arthropathy.   

Lead pipe appearance of the colon (red arrows).

Ankylosis of the left sacroiliac joint and partial ankylosis on the right (yellow arrow). 

Case Discussion

A nice example of the lead pipe sign of chronic ulcerative colitis and of enteropathy associated arthritis with chronic bilateral sacroiliitis and left hip joint arthropathy.  

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