AB0513 THE RELATIONSHIP OF PERIARTICULAR TISSUES LESIONS AND JOINTS DEGENERATIVE CHANGES IN PATIENTS WITH INFLAMMATORY BOWEL DISEASES
Authors: G. Gainullina, E. Kirillova, D. Abdulganieva, E. Belousova, A. Odincova
Journal: Annals of the Rheumatic Diseases (2021)

Background: Inflammatory bowel diseases (IBD) are associated with a variety of extra-intestinal manifestations. The most frequent of these is joint involvement, which affects 16–33 % of IBD patients, whereas 5–10 % are affected by enthesitis [1, 2]. Recent studies have shown the superiority of ultrasound over clinical findings in the evaluation of joints and periarticular tissues [3]. Objectives: To assess of joint and entheseal involvement in patients with Crohn’s disease (CD) and ulcerative colitis (UC) using ultrasound with Power Doppler. Methods: We prospectively included 70 IBD patients into the study. Peripheral joints and entheses were imaged by ultrasound, using Samsung Accuvix A30 5-13 MHz linear array transducer. Ultrasound examination of 14 peripheral joints (hip, knee, ankle, shoulder, acromioclavicular, elbow, wrist) and 35 entheses was performed. Vascularization was assessed with Power Doppler (PD). Statistical analysis was done by Mann-Whitney test by “Statistica” software. Results: In 70 patients UC was in 40 (57%), CD - in 30 (43%). The mean age of patients was 32 (27; 36) years. The mean duration of the disease was 48 (12; 84) months. The majority of patients had highly active disease: moderate and severe activity was observed in 47 (67%). Osteophytes were found in 32 (46%) IBD pts, in 10 pts (14%) - osteophytes were found in three or more joints. We divided pts into two groups. In first group we included pts without degenerative changes in the joints, in the second - with identified osteophytes. Osteophytes were found more often in the acromioclavicular joints - 13 pts (41%) and in the hip joints - 10 pts (31%). With the same frequency (9 pts), osteophytes were detected in the wrist, knee and ankle joints. The mean age of pts and mean duration of IBD were significantly higher in the second group patients (p = 0.00002 and p = 0.019). Enthesitis (echogenicity reduction and thickening) without vascularization were detected in 26 patients of the first group (68%) and 29 patients of the second group (91%) (p = 0.009). The rate of vascularized enthesitis in the two groups was the same: enthesitis with vascularization were observed in 14 pts of the first group (37%) and 14 of the second group (44%) (p = 0.822). Structure damage (erosions and enthesophytis) was more frequent in the second group (p = 0.025 and p = 0.001). There were no significant differences in the incidence of tendinitis and tenosynovitis between two groups. Conclusion: Joint and periarticular tissues damage in IBD patients increases with age and duration of the disease. The presence of degenerative changes in the joints is associated with more frequent detection of enthesitis and enthesopathies. References: [1]The First European Evidence-based Consensus on Extra-Intestinal Manifestations in IBD. JCC. 2016; 10 (3): 239-254. [2]Rovisco J, Duarte C, Batticcioto A et al. Hidden musculoskeletal involvement in inflammatory bowel disease: a multicenter ultrasound study. BMC Musculoskelet Disord. 2016; 17: 84. [3]Yu-Fen Hsiao, Shu-Chen Wei, Cheng-Hsun Lu et al. Patients with Inflammatory Bowel Disease have Higher Sonographic Enthesitis Scores than Normal Individuals: Pilot Study in Taiwan. Journal of Medical Ultrasound. 2014 Dec; 22(4): 194-199. Disclosure of Interests: None declared.