Patients with Inflammatory Bowel Disease have Higher Sonographic Enthesitis Scores than Normal Individuals: Pilot Study in Taiwan

Hsiao, Yu-Fen; Wei, Shu–Chen; Lu, Cheng‐Hsun; Wu, Cheng-Han; Hsieh, Song-Chou; Li, Ko-Jen

doi:10.1016/j.jmu.2014.03.004

Cited by 7 publications

(5 citation statements)

References 28 publications

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“…In our study, we found two groups of patients: the first those with predominantly axial involvement who present with abdominal pain, rectal bleeding and architecture alteration in the ileum and the second patients with enthesitis and acute inflammation of the ileum; this association between higher enthesitis scores and IBD has been previously described [ 24 ]; however, this observation must be confirmed in subsequent studies.…”

Section: Discussionsupporting

confidence: 71%

Implementation of screening criteria for inflammatory bowel disease in patients with spondyloarthritis and its association with disease and endoscopic activity

et al. 2022

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There is little literature on the implementation of screening criteria for inflammatory bowel disease (IBD) in patients with spondyloarthritis (SpA). This study aimed to apply IBD screening criteria in a group of patients with SpA without IBD diagnosis and correlate them to endoscopic findings and disease activity. A total of 82 patients with SpA were included. The IBD screening test and ileocolonoscopy with digital chromoendoscopy with magnification and histological analysis were performed. The data were analysed with Chi-square test/Fisher’s exact test and multiple correspondence analysis. The major screening criteria found in 48.7% of the patients were associated with a history of infection (p = 0.037). Rectal bleeding was associated with the diagnosis of ankylosing spondylitis, acute inflammation, enthesitis and tissue architecture alteration in the ileum (p < 0.050). Diarrhoea was associated with a higher disease activity score (p = 0.02). Minor screening criteria were associated with painful inflammatory joint (p = 0.05), high disease activity score (p = 0.001) and high calprotectin levels (p = 0.050). Abdominal pain (36.9%) was associated with axial/peripheral compromise (p = 0.017), inflammatory back pain (p = 0.01), enthesitis (p = 0.021), higher disease activity score (p = 0.023) and acute ileum inflammation (p = 0.046). Diarrhoea of 4 weeks and abdominal pain were the most prevalent major and minor screening criteria, respectively, being related to early manifestations of inflammatory bowel compromise and higher disease activity score. This screening test grants a chance of opportune referral of SpA patients from rheumatology to gastroenterology.

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Section: Discussionsupporting

confidence: 71%

Implementation of screening criteria for inflammatory bowel disease in patients with spondyloarthritis and its association with disease and endoscopic activity

et al. 2022

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“…All of these studies allowed to derive information on the frequency of lesions, while only three studies presented data on the diagnostic accuracy of ultrasonographic findings to identify patients with arthritis among patients with IBD ( 22 , 24 , 25 ). Three studies had a case-control design ( 15 , 23 , 24 ), while the remaining were cross-sectional studies. The absence of prospective studies, therefore, did not allow to retrieve any evidence on the value of musculoskeletal ultrasound to define prognosis and to monitor joint and entheseal lesions.…”

Section: Resultsmentioning

confidence: 99%

“…Six studies applied semi-quantitative scoring systems to assesses entheses, in particular the Glasgow Ultrasound Enthesitis Scoring System (GUESS) ( 15 , 22 , 23 , 25 ) and the Madrid Sonographic Enthesitis Index (MASEI) ( 22 , 24 , 25 ) were adopted by four and three studies, respectively. The use of high-end ultrasound equipment was reported by five studies ( 22 , 24 – 27 ), all of the studies were performed after 2010, which likely implies technically comparable equipment.…”

Section: Resultsmentioning

confidence: 99%

“…When analyzing specific sites, the only lesion reported at the triceps tendon was increased thickness, while at the remaining sites for which frequency data were available in detail (quadriceps tendon, proximal and distal patellar tendon, Achilles tendon and plantar fascia) all lesions were assessed. Frequencies were reported based on the total number of patients in some studies ( 15 , 22 , 24 – 26 , 28 ), while in some others on the number of assessed entheses ( 23 , 27 ). Specifically, increased thickness was more frequently reported at the distal patellar tendon (range 6.43% of entheses to 58% of patients), hypoechogenicity was found more frequently at the Achilles tendon (33.7% of sites), as well as PD (from 0% of patients to 20.9% of sites), enthesophytes (from 1.42% of sites to 56.8% of patients) and calcifications (2.3% of sites).…”

Section: Resultsmentioning

confidence: 99%

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Musculoskeletal Ultrasound to Identify Subclinical Joint and Periarticular Involvement in Patients With Inflammatory Bowel Disease: A Systematic Literature Review

et al. 2022

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BackgroundMusculoskeletal ultrasonography identifies subclinical joint and entheseal inflammation, and it might be of value in patients with inflammatory bowel diseases (IBD), which are at higher risk of inflammatory arthropathy and disability. Our aim was to retrieve the evidence on the applications of ultrasound in patients with non-arthropathic IBD.MethodsStudies enrolling patients with IBD without arthritis, undergoing ultrasound of joints, tendons or entheses were eligible. The outcomes of interest encompassed the frequency of ultrasound-detected lesions, their accuracy in diagnosing arthritis, their prognostic role and sensitivity to change. All study types, excluding case reports, case series and narrative reviews, were included. Search strategies were applied in PubMed and Embase. Abstract and full-texts were evaluated by pairs of reviewers. The risk of bias was evaluated through the Newcastle-Ottawa scale or the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) 2. The protocol was registered in PROSPERO (CRD42021264972).ResultsOut of 2,304 records, eight studies were included, all reporting the frequency of lesions, while only three evaluated also the diagnostic accuracy. All studies had a cross-sectional design, with no evidence on prediction or follow-up. All studies evaluated the entheses, while only three the joints. The most common chronic lesions were entheseal thickening (up to 81.5%) and enthesophytes (67.9%), while entheseal erosions were present in 16%−17% of patients. Among inflammatory lesions, power Doppler was reported in 14%−67% of patients. There were no differences among Crohn's disease or ulcerative colitis and depending on disease activity, while there were contrasting results on different disease durations. When evaluating the diagnostic performance, the best specificity for a diagnosis if IBD was 0.88 (95%CI, 0.8–0.94) for joint abnormalities. Also, the best sensitivity was 0.88 (95%CI, 0.76–0.95) for entheseal lesions. No studies assessed of the combination of lesions. Due to the limited number of studies, meta-analyses were not performed.ConclusionsDespite the possible value of ultrasound in IBD, there is limited evidence deriving from cross-sectional studies. Longitudinal studies are needed to clarify the role of this technique, while its current placement might be that of complementing clinical assessment, in particular in early intestinal disease.

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“…There are many sonographic quantitative scoring systems for enthesitis evaluation, including the Glasgow Ultrasound Enthesitis Scoring System (GUESS), Mander Enthesitis Index (MEI), and the Madrid Sonographic Enthesitis Index (MASEI) [3e5]. In this issue of the Journal of Medical Ultrasound, Hsiao et al report a pilot study using GUESS to evaluate enthesitis in patients with and without IBD [6]. Subclinical enthesopathy with higher GUESS scores were found in patients with IBD.…”

mentioning

confidence: 99%

Clinical Application of Musculoskeletal Ultrasound in Rheumatology

Hsiao

Li²

2014

Journal of Medical Ultrasound

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Patients with Inflammatory Bowel Disease have Higher Sonographic Enthesitis Scores than Normal Individuals: Pilot Study in Taiwan

Cited by 7 publications

References 28 publications

Implementation of screening criteria for inflammatory bowel disease in patients with spondyloarthritis and its association with disease and endoscopic activity

Implementation of screening criteria for inflammatory bowel disease in patients with spondyloarthritis and its association with disease and endoscopic activity

Musculoskeletal Ultrasound to Identify Subclinical Joint and Periarticular Involvement in Patients With Inflammatory Bowel Disease: A Systematic Literature Review

Clinical Application of Musculoskeletal Ultrasound in Rheumatology

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