Ulcerative colitis

Image Challenge: What's your Comment?

Data:
Age: 45
Gender: Male

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

Correct Answer: Ulcerative colitis with lead pipe appearance and arthopathy.

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

**Lead pipe appearance of colon is the classical barium enema finding in chronic ulcerative colitis. There is complete loss of haustral markings in the diseased section of colon, and the organ appears smooth walled and cylindrical. **