Fardina Malik1, Ellen Scherl2, Ulrich Weber3,4, John A Carrino5, Madeline Epsten6, Stephanie Wichuk7, Susanne J Pedersen8, Joel Paschke9, Sergio Schwartzman10, Georg Kroeber3, Walter P Maksymowych7,9, Randy Longman2, Lisa A Mandl11. 1. Division of Rheumatology, Department of Medicine, NYU School of Medicine, New York, NY, USA. 2. Weill Cornell Medicine, Jill Roberts Institute for Research in Inflammatory Bowel Disease, New York, NY, USA. 3. Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sønderborg, Denmark. 4. Department of Regional Health Research, University of Southern Denmark, Odense, Denmark. 5. Department of Radiology and Imaging, Hospital for Special Surgery and Weill Cornell Medicine, New York, NY, USA. 6. Rush Medical School, Chicago, IL, USA. 7. University of Alberta, Edmonton, AB, Canada. 8. Copenhagen Center for Arthritis Research, Rigshospitalet-Glostrup, University of Copenhagen, Copenhagen, Denmark. 9. CARE Arthritis, Edmonton, AB, Canada. 10. Department of Medicine, Weill Cornell Medicine, New York, NY, USA. 11. Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, and Weill Cornell Medicine, New York, NY, USA.
Abstract
OBJECTIVE: Prevalence of sacroiliitis in Crohn's disease (CD) is variable depending on defining criteria. This study utilized standardized sacroiliac joint (SIJ) magnetic resonance imaging (MRI) to identify sacroiliitis in CD patients and its association with clinical and serological markers. METHODS: Consecutive adult subjects with CD prospectively enrolled from an inflammatory bowel disease clinic underwent SIJ MRI. Data collected included CD duration, history of joint/back pain, human leukocyte antigen-B27 status, Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing Spondylitis Disease Activity Index, Harvey Bradshaw Index (HBI) for activity of CD, Ankylosing Spondylitis Disease Activity Score, and various serologic markers of inflammation. Three blinded readers reviewed MRIs for active and structural lesions according to the Spondyloarthritis Research Consortium of Canada modules. RESULTS: Thirty-three CD patients were enrolled: 76% female, 80% White, median age 36.4 years (interquartile range 27.2-49.0), moderate CD activity (mean HBI 8.8 ± SD 4.5). Nineteen subjects (58%) reported any back pain, 13 of whom had inflammatory back pain. Four subjects (12%) showed sacroiliitis using global approach and 6 (18%) met Assessment of SpondyloArthritis international Society MRI criteria of sacroiliitis. Older age (mean 51.2 ± SD 12.5 vs. 37.2 ± 14; P = .04), history of dactylitis (50.0% vs. 3.4%, P = .03) and worse BASMI (4.1 ± 0.7 vs. 2.4 ± 0.8, P ≤ .001) were associated with MRI sacroiliitis; no serologic measure was associated. CONCLUSION: There were 12%-18% of CD patients who had MRI evidence of sacroiliitis, which was not associated with back pain, CD activity or serologic measures. This data suggests that MRI is a useful modality to identify subclinical sacroiliitis in CD patients.
OBJECTIVE: Prevalence of sacroiliitis in Crohn's disease (CD) is variable depending on defining criteria. This study utilized standardized sacroiliac joint (SIJ) magnetic resonance imaging (MRI) to identify sacroiliitis in CD patients and its association with clinical and serological markers. METHODS: Consecutive adult subjects with CD prospectively enrolled from an inflammatory bowel disease clinic underwent SIJ MRI. Data collected included CD duration, history of joint/back pain, human leukocyte antigen-B27 status, Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing Spondylitis Disease Activity Index, Harvey Bradshaw Index (HBI) for activity of CD, Ankylosing Spondylitis Disease Activity Score, and various serologic markers of inflammation. Three blinded readers reviewed MRIs for active and structural lesions according to the Spondyloarthritis Research Consortium of Canada modules. RESULTS: Thirty-three CD patients were enrolled: 76% female, 80% White, median age 36.4 years (interquartile range 27.2-49.0), moderate CD activity (mean HBI 8.8 ± SD 4.5). Nineteen subjects (58%) reported any back pain, 13 of whom had inflammatory back pain. Four subjects (12%) showed sacroiliitis using global approach and 6 (18%) met Assessment of SpondyloArthritis international Society MRI criteria of sacroiliitis. Older age (mean 51.2 ± SD 12.5 vs. 37.2 ± 14; P = .04), history of dactylitis (50.0% vs. 3.4%, P = .03) and worse BASMI (4.1 ± 0.7 vs. 2.4 ± 0.8, P ≤ .001) were associated with MRI sacroiliitis; no serologic measure was associated. CONCLUSION: There were 12%-18% of CD patients who had MRI evidence of sacroiliitis, which was not associated with back pain, CD activity or serologic measures. This data suggests that MRI is a useful modality to identify subclinical sacroiliitis in CD patients.
Authors: Wolfgang Hueber; Bruce E Sands; Steve Lewitzky; Marc Vandemeulebroecke; Walter Reinisch; Peter D R Higgins; Jan Wehkamp; Brian G Feagan; Michael D Yao; Marek Karczewski; Jacek Karczewski; Nicole Pezous; Stephan Bek; Gerard Bruin; Bjoern Mellgard; Claudia Berger; Marco Londei; Arthur P Bertolino; Gervais Tougas; Simon P L Travis Journal: Gut Date: 2012-05-17 Impact factor: 23.059
Authors: Ulrich Weber; Robert G W Lambert; Mikkel Østergaard; Juerg Hodler; Susanne J Pedersen; Walter P Maksymowych Journal: Arthritis Rheum Date: 2010-10
Authors: M Rudwaleit; R Landewé; D van der Heijde; J Listing; J Brandt; J Braun; R Burgos-Vargas; E Collantes-Estevez; J Davis; B Dijkmans; M Dougados; P Emery; I E van der Horst-Bruinsma; R Inman; M A Khan; M Leirisalo-Repo; S van der Linden; W P Maksymowych; H Mielants; I Olivieri; R Sturrock; K de Vlam; J Sieper Journal: Ann Rheum Dis Date: 2009-03-17 Impact factor: 19.103
Authors: J Sieper; M Rudwaleit; X Baraliakos; J Brandt; J Braun; R Burgos-Vargas; M Dougados; K-G Hermann; R Landewé; W Maksymowych; D van der Heijde Journal: Ann Rheum Dis Date: 2009-06 Impact factor: 19.103