Digital Public Defence: Alvilde Maria Ossum Alvilde Maria Ossum at Institute of Clinical Medicine will be defending the thesis Musculoskeletal manifestations in inflammatory  bowel disease and their association with health-related quality of life and fatigue. Results after 20 years of follow-up in the prospective and population-based IBSEN study for the degree of PhD (Philosophiae Doctor).

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The public defence will be held as a video conference over Zoom.

The defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.

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Due to copyright reasons, an electronic copy of the thesis must be ordered from the faculty. In order for the faculty to have time to process the order, it must be received by the faculty no later than 2 days prior to the public defence. Orders received later than 2 days before the defence will not be processed. Inquiries regarding the thesis after the public defence must be addressed to the candidate.

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Adjudication committee

  • First opponent: Chief Physician Ida Vind, Hvidovre University Hospital, Copenhagen, Denmark
  • Second opponent: Chief Physician Guro Løvik Goll, Diakonhjemmet Hospital, Oslo
  • Third member and chair of the evaluation committee: Professor Tore Julsrud Berg, Institute of Clinical Medicine, University of Oslo

Chair of defence

Professor Emeritus Arild Nesbakken, Institute of Clinical Medicine, University of Oslo

Principal Supervisor

Associate Professor Marte Lie Høivik, Institute of Clinical Medicine, University of Oslo


Patients with inflammatory bowel disease (IBD), a chronic gastrointestinal disease, often suffer from extraintestinal manifestations. These present most commonly as musculoskeletal conditions encompassing axial and peripheral spondyloarthritides. IBD, spondyloarthritides and pain may all have a negative impact on physical health as well as quality of life. 

The aims of this thesis were to investigate the occurrence of musculoskeletal manifestations in IBD patients after long-term disease, and to assess  whether such manifestations were associated with quality of life and fatigue. 

This thesis emanates from the IBSEN study, a prospective population-based cohort following IBD patients for 20 years after diagnosis. The classification of musculoskeletal manifestations, as well as quality of life and fatigue, were based on questionnaires and clinical assessments at pre-scheduled follow-ups. 

After 20 years, 599 (79.2 %) from the original cohort were alive, of whom 470 (78.5 %) participated at the final follow-up. A detailed rheumatic questionnaire enabled classification of the musculoskeletal conditions, and the 441 patients (93.8 %) who completed this, were included in this thesis. 

Ankylosing spondylitis (Bekhterev’s disease) was found in 4.5 % of the patients, axial spondyloarthritis in 7.7 %, and peripheral spondyloarthritis in 27.9 %, while ongoing arthralgia (joint pain) or back pain was reported by more than 45 % of the patients. 
Arthralgia and back pain were associated with reduced quality of life and fatigue, but after adjusting for possible confounders, the diagnosis spondyloarthritis (axial and peripheral combined) was not. 

A high occurrence of musculoskeletal symptoms and diagnoses was found in IBD patients 20 years after diagnosis. The impact these symptoms can have on quality of life, underlines the importance of awareness regarding the coexistence of IBD with musculoskeletal manifestations in both clinical follow-up and treatment. 

Additional information

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Published Mar. 5, 2021 1:33 PM - Last modified Mar. 22, 2021 9:09 AM