Background Spondyloarthritis (SpA) occurs in up to 20% of patients with inflammatory bowel disease (IBD) . Symptomatic enthesitis is a characteristic feature of SpA and represents an early sign of SpA . The prevalence of enthesitis in patients with IBD is not known.
Objectives This study was designed to evaluate whether patients with IBD showed an increased prevalence of entheseal involvement, even in the absence of clinical symptoms.
Methods Thirty-five IBD patients (25 M and 10 F, median age 41 yrs), 25 with Crohn's disease (CD) and 10 with ulcerative colitis (UC), all with moderate intestinal activity, and 22 (13 M and 12 F, median age 44 yrs) control subjects with irritable bowel syndrome underwent a thorough clinical evaluation followed by entheses ultrasonography of upper limb (brachial triceps) and lower limb (quadriceps, proximal and distal rotuleus, Achilles tendon and plantar fascia). The Madrid sonographic entheses index (MASEI) was used to score entheses abnormalities [thickness, enthesophytosis, bursitis, erosions with and without power doppler (PD)]. Correlation between IBD features (type, duration and activity), age, sex and MASEI score was assessed with nonlinear Spearman's rho. Significance of differences was assessed by chi-square test. The level of statistical significance of differences was set at p
Results All of 35 patients with IBD presented at least one entheses alteration with a mean MASEI of 5.43 (thickness 57.1%, enthesophytosis 42.8%, bursitis 0%, erosions 0%, PD abnormalities 14.2%) vs 3 patients of control group (enthesophytosis 14%) (p
Conclusions 1) IBD patients showed a significantly higher prevalence of early entheses involvement, even in the absence of clinical symptoms; 2) the entity of entheses alteration as assessed by MASEI did not correlate with type, duration and activity of IBD; 3) age was the only variable which significantly correlated with ultrasonographic entheses involvement.; 4) we speculate that IBD patients should undergo ultrasonography evaluation of entheses and, if any alteration, be followed up for early detection of SpA.
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Disclosure of Interest None declared