Rusmir Husic1, Angelika Lackner1, Patrizia Katharina Kump2, Christoph Högenauer2, Winfried Graninger1, Christian Dejaco1,3. 1. Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria. 2. Department of Gastroenterology and Hepatology, Medical University Graz, Graz, Austria. 3. Department of Rheumatology, Hospital of Brunico (Südtiroler Sanitätsbetrieb-Azienda Sanitaria dell'Alto Adige), Brunico, Italy.
Abstract
Background: Inflammatory bowel disease (IBD) is closely associated with spondylarthritis (SpA) and enthesitis, as an important feature of SpA, is a common extraintestinal manifestation of IBD. Enthesitis may be clinically silent in a high proportion of patients with IBD without clinical signs or a diagnosis of SpA. Objectives: The aim of this study was to compare the prevalence of ultrasound (US) verified enthesitis in IBD patients with and without SpA, with patients with irritable bowel syndrome (IBS) and healthy subjects (HC) serving as controls. Methods: IBD patients with or without SpA, patients with IBS and HC were prospectively recruited and clinically assessed. Ultrasound examination was performed at 14 entheses. The ultrasound abnormalities were scored according to the Madrid Ankylosing Spondylitis Enthesitis Index (MASEI). Results: We included 33 IBD patients without SpA, 14 IBD patients with SpA, 26 IBS patients and 18 HC. Higher MASEI scores were found in patients with IBD without SpA [median 21.0 range (8.0-53.0)] and IBD associated SpA [33.0 (8-50)] than in IBS patients [10.5 (0-42.0)-p < 0.001 for both comparison] and HC [12.0 (2.0-38.0)-p < 0.01]. PD, enthesophytes and erosions were more common in patients with IBD with or without SpA as compared to IBS patients and HC. IBD patients with SpA compared to IBD without SpA demonstrated significant higher prevalence of erosion and structural irregularity and consequently significant higher MASEI (p < 0.05 for all comparison). Conclusions: Ultrasound verified enthesitis is more common in patients with IBD with or without SpA as compared to patients with IBS or HC.
Background: Inflammatory bowel disease (IBD) is closely associated with spondylarthritis (SpA) and enthesitis, as an important feature of SpA, is a common extraintestinal manifestation of IBD. Enthesitis may be clinically silent in a high proportion of patients with IBD without clinical signs or a diagnosis of SpA. Objectives: The aim of this study was to compare the prevalence of ultrasound (US) verified enthesitis in IBDpatients with and without SpA, with patients with irritable bowel syndrome (IBS) and healthy subjects (HC) serving as controls. Methods:IBDpatients with or without SpA, patients with IBS and HC were prospectively recruited and clinically assessed. Ultrasound examination was performed at 14 entheses. The ultrasound abnormalities were scored according to the Madrid Ankylosing Spondylitis Enthesitis Index (MASEI). Results: We included 33 IBDpatients without SpA, 14 IBDpatients with SpA, 26 IBSpatients and 18 HC. Higher MASEI scores were found in patients with IBD without SpA [median 21.0 range (8.0-53.0)] and IBD associated SpA [33.0 (8-50)] than in IBSpatients [10.5 (0-42.0)-p < 0.001 for both comparison] and HC [12.0 (2.0-38.0)-p < 0.01]. PD, enthesophytes and erosions were more common in patients with IBD with or without SpA as compared to IBSpatients and HC. IBDpatients with SpA compared to IBD without SpA demonstrated significant higher prevalence of erosion and structural irregularity and consequently significant higher MASEI (p < 0.05 for all comparison). Conclusions: Ultrasound verified enthesitis is more common in patients with IBD with or without SpA as compared to patients with IBS or HC.
Authors: Rusmir Husic; Judith Gretler; Anja Felber; Winfried B Graninger; Christina Duftner; Josef Hermann; Christian Dejaco Journal: Ann Rheum Dis Date: 2013-06-05 Impact factor: 19.103
Authors: M Rudwaleit; D van der Heijde; R Landewé; N Akkoc; J Brandt; C T Chou; M Dougados; F Huang; J Gu; Y Kirazli; F Van den Bosch; I Olivieri; E Roussou; S Scarpato; I J Sørensen; R Valle-Oñate; U Weber; J Wei; J Sieper Journal: Ann Rheum Dis Date: 2010-11-24 Impact factor: 19.103
Authors: H Mielants; E M Veys; C Cuvelier; M De Vos; S Goemaere; L De Clercq; L Schatteman; L Gyselbrecht; D Elewaut Journal: J Rheumatol Date: 1995-12 Impact factor: 4.666