TY - ABST
T1 - Spine, and Sacroiliac Joint Involvement in Newly Diagnosed Patients with Inflammatory Bowel Disease – Clinical and MRI Findings from a Population-Based Cohort Study
AU - Vladimirova, Nora
AU - Møller, Jakob
AU - Attauabi, Mohamed
AU - Madsen, Gorm
AU - Seidelin, Jakob
AU - Terslev, Lene
AU - Wiell, Charlotte
AU - Fana, Viktoria
AU - Hansen, Sanja Bay
AU - Siebner, Hartwig Roman
AU - Bendtsen, Flemming
AU - Gosvig, Kasper Kjærulf
AU - Burisch, Johan
AU - Østergaard, Mikkel
N1 - COPECARE
Copyright © 2024 by The American College of Gastroenterology.
PY - 2024/11
Y1 - 2024/11
N2 - INTRODUCTION: In patients with inflammatory bowel disease (IBD), co-occurring spondyloarthritis (SpA) leads to poorer outcomes and impaired quality of life, highlighting the importance of early detection and effective treatment. This is the first study to assess the prevalence and distribution of axial symptoms and magnetic resonance imaging (MRI)-detected involvement of the spine and sacroiliac joints (SIJs) in early IBD.METHODS: Newly diagnosed patients with IBD from a prospective, population-based cohort were consecutively recruited. Rheumatological interview, clinical, ultrasound, and MRI assessment for SIJ and spine inflammatory and structural lesions were made using validated scoring methods and consensus definitions of axial SpA (axSpA).RESULTS: Of 110 patients (ulcerative colitis: 70, Crohn's disease: 40, mean age of 42 years, and 40% male), 48 (44.9%) reported back and/or buttock pain, and 10 (9.1%) had inflammatory back pain. Seventeen (16.7%) patients had MRI findings indicative of axSpA; only 10 of these patients had axial symptoms. Inflammatory MRI lesions were present in SIJs and the spine of 27 (26.5%) and 30 (30.3%) patients, respectively. The Assessment of SpondyloArthritis International Society classification criteria for axSpA were met in 11 (10%) cases. MRI findings typical of axSpA were associated with peripheral joint and entheseal inflammation detected by ultrasound ( P = 0.04). No differences in clinical or imaging findings were found between patients with ulcerative colitis and Crohn's disease.DISCUSSION: One-in-6 newly diagnosed patients with IBD had MRI findings indicative of axSpA. As 40% of these patients were asymptomatic, this suggests that axSpA is underdiagnosed in early IBD. Multidisciplinary collaboration is essential to ensure early detection of axial inflammation and to enable optimal therapy preventing future structural damage and disability.
AB - INTRODUCTION: In patients with inflammatory bowel disease (IBD), co-occurring spondyloarthritis (SpA) leads to poorer outcomes and impaired quality of life, highlighting the importance of early detection and effective treatment. This is the first study to assess the prevalence and distribution of axial symptoms and magnetic resonance imaging (MRI)-detected involvement of the spine and sacroiliac joints (SIJs) in early IBD.METHODS: Newly diagnosed patients with IBD from a prospective, population-based cohort were consecutively recruited. Rheumatological interview, clinical, ultrasound, and MRI assessment for SIJ and spine inflammatory and structural lesions were made using validated scoring methods and consensus definitions of axial SpA (axSpA).RESULTS: Of 110 patients (ulcerative colitis: 70, Crohn's disease: 40, mean age of 42 years, and 40% male), 48 (44.9%) reported back and/or buttock pain, and 10 (9.1%) had inflammatory back pain. Seventeen (16.7%) patients had MRI findings indicative of axSpA; only 10 of these patients had axial symptoms. Inflammatory MRI lesions were present in SIJs and the spine of 27 (26.5%) and 30 (30.3%) patients, respectively. The Assessment of SpondyloArthritis International Society classification criteria for axSpA were met in 11 (10%) cases. MRI findings typical of axSpA were associated with peripheral joint and entheseal inflammation detected by ultrasound ( P = 0.04). No differences in clinical or imaging findings were found between patients with ulcerative colitis and Crohn's disease.DISCUSSION: One-in-6 newly diagnosed patients with IBD had MRI findings indicative of axSpA. As 40% of these patients were asymptomatic, this suggests that axSpA is underdiagnosed in early IBD. Multidisciplinary collaboration is essential to ensure early detection of axial inflammation and to enable optimal therapy preventing future structural damage and disability.
KW - Adult
KW - Axial Spondyloarthritis/diagnostic imaging
KW - Cohort Studies
KW - Colitis, Ulcerative/diagnostic imaging
KW - Crohn Disease/diagnostic imaging
KW - Female
KW - Humans
KW - Inflammatory Bowel Diseases/diagnostic imaging
KW - Magnetic Resonance Imaging
KW - Male
KW - Middle Aged
KW - Prevalence
KW - Prospective Studies
KW - Sacroiliac Joint/diagnostic imaging
KW - Spine/diagnostic imaging
KW - Spondylarthritis/diagnostic imaging
KW - Ultrasonography
KW - Arthritis
KW - Inflammation
KW - Spondyloarthritis
KW - Inflammatory bowel disease
KW - Magnetic resonance imaging
M3 - Conference abstract for conference
SP - Arthritis & Rheumatology 76 (suppl 9), abstract no. 0230
T2 - ACR Convergence 2024
Y2 - 14 November 2024 through 19 November 2024
ER -