BACKGROUND: Musculoskeletal symptoms belonging to the spectrum of spondyloarthritis' (SpA) are the most common extraintestinal patients with inflammatory bowel disease (IBD) and may lead to important burden. Patients with suspected SpA should be referred to a further evaluation. OBJECTIVE: To investigate the self-reported musculoskeletal SpA features in a cohort of patients with IBD and to with actual referrals to a rheumatologist. METHODS: Consecutive patients visiting the outpatient clinic were interviewed by a trained research possible SpA features using a standardized questionnaire regarding the or history of inflammatory back pain, peripheral arthritis, enthesitis, dactylitis, psoriasis, uveitis and response to nonsteroidal anti- drugs. All patient files were verified for previous visits to a and any rheumatic diagnosis. RESULTS: At least one musculoskeletal SpA was reported by 129 of 350 (36.9%) patients. No significant differences patients with Crohn disease and ulcerative colitis were found. Review of records showed that 66 (51.2%) patients had ever visited a SpA was diagnosed in 18 (27.3%) patients, peripheral SpA in 20 (30.3%) and another rheumatic disorder in 14 (21.2%) patients. CONCLUSION: Musculoskeletal SpA features are frequently present in patients with However, a substantial group of patients is not evaluated by a Gastroenterologists play a key role in early referral of this often disease.