Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Feb 12:8:637459.
doi: 10.3389/fmed.2021.637459. eCollection 2021.

High Prevalence of Ultrasound Verified Enthesitis in Patients With Inflammatory Bowel Disease With or Without Spondylarthritis

Rusmir Husic  1 , Angelika Lackner  1 , Patrizia Katharina Kump  2 , Christoph Högenauer  2 , Winfried Graninger  1 , Christian Dejaco  1   3
Affiliations

High Prevalence of Ultrasound Verified Enthesitis in Patients With Inflammatory Bowel Disease With or Without Spondylarthritis

Rusmir Husic et al. Front Med (Lausanne). .

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.

Keywords: enthesitis; inflammatory bowel diseases; power Doppler ultrasonography; spondyloarthropathies; ultrasound.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Examples of ultrasound findings. (A) Longitudinal scan of a achilles tendon revealing active PD signal (arrows heads), enthesophyt (white arrow), erosion on insertion (blue arrow), (B) longitudinal scan of tendon insertion on lateral epicondyl with PD signal (arrow heads), t-tendon.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. McGonagle D, Khan MA, Marzo-Ortega H, O'Connor P, Gibbon W, Emery P. Enthesitis in spondyloarthropathy. Curr Opin Rheumatol. (1999) 11:244–50. 10.1097/00002281-199907000-00004 - DOI - PubMed
    1. McGonagle D, Gibbon W, Emery P. Classification of inflammatory arthritis by enthesitis. Lancet. (1998) 352:1137–40. 10.1016/S0140-6736(97)12004-9 - DOI - PubMed
    1. Turkcapar N, Toruner M, Soykan I, Aydintug OT, Cetinkaya H, Duzgun N, et al. . The prevalence of extraintestinal manifestations and HLA association in patients with inflammatory bowel disease. Rheumatol Int. (2006) 26:663–8. 10.1007/s00296-005-0044-9 - DOI - PubMed
    1. Harbord M, Annese V, Vavricka SR, Allez M, Acosta MB, de, Boberg KM, et al. . The first european evidence-based consensus on extra-intestinal manifestations in inflammatory bowel disease. J Crohn's Colitis. (2016) 10:239–54. 10.1093/ecco-jcc/jjv213 - DOI - PMC - PubMed
    1. Mielants H, Veys EM, Cuvelier C, De Vos M, Goemaere S, De Clercq L, et al. . The evolution of spondyloarthropathies in relation to gut histology. III. Relation between gut and joint. J Rheumatol. (1995) 22:2279–84. - PubMed