Spondyloarthropathy associated with inflammatory bowel disease (IBD) is one of forms of seronegative spondyloarthropathies (SpA). Both groups of diseases may have common pathogenesis. In the course of IBD, in 20–50% of patients peripheral or axial arthritis is observed, while in 30–60% of patients with SpA microscopic gut inflammation can be diagnosed. This situation can lead to the diagnostic difficulties as it was shown in this paper with an example of a 25-year-old woman with a family history of IBD, history of peripheral arthritis and with signs of inflammatory back pain. Radiograms showed bilateral sacroiliitis (Fig. 1 and 2), no important changes in the spine (Fig. 3 and 4) and hips (Fig. 5). In endoscopy, the features of IBD were observed (asymptomatic). Finally, in our patient SpA associated with IBD was diagnosed. Examining SpA patients for gut inflammation is important because of prognostic and therapeutic implications.