Ultrasonographic and clinical assessment of peripheral enthesitis and arthritis in an Italian cohort of inflammatory bowel disease patients

Bertolini, Elena; Macchioni, Pierluigi; Rizzello, Fernando; Salice, Marco; Vukatana, G.; Sandri, Gilda; Bertani, A.; Ciancìo, Giovanni; Govoni, Marcello; Zelante, A.; Malavolta, Nazzarena; Beltrami, Marina; Salvarani, Carlo

doi:10.1016/j.semarthrit.2020.01.001

Cited by 14 publications

(19 citation statements)

References 42 publications

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“…Of 2,304 abstracts evaluated, eight studies were finally included ( 15 , 22 – 27 ). Of those, seven articles were retrieved from the electronic databases and one by hand search ( Figure 1 ) ( 28 ).…”

Section: Resultsmentioning

confidence: 99%

“…The total number of included patients was 679. 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.…”

Section: Resultsmentioning

confidence: 99%

“…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. All of the included studies assessed various entheseal sites ( Table 2 ), while only three included also an evaluation of joints ( 22 , 26 , 28 ). A single study reported scanning synovial tendons ( 22 ).…”

Section: Resultsmentioning

confidence: 99%

“…All of the included studies assessed various entheseal sites ( Table 2 ), while only three included also an evaluation of joints ( 22 , 26 , 28 ). A single study reported scanning synovial tendons ( 22 ). In particular, the quadriceps tendon, the proximal and distal patellar tendons, the Achilles tendon and plantar fascia were assessed in all of the studies, the insertion of the common extensor tendon at the epicondyle in 4 studies ( 22 , 24 , 25 , 28 ), the triceps tendon ( 27 ) and the insertion of the common flexor tendon at the medial epicondyle in one study each ( 28 ).…”

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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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

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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“…A recent multicenter cross-sectional study found that patients with IBDs and SpA had higher MASEI score than those with IBDs and fibromyalgia [46]. Finally, a multicenter cross-sectional study including 148 IBD patients revealed gray-scale entheseal involvement in 87.8% of cases, with positive entheseal power Doppler in 29.7% [47].…”

Section: Entheses and Tendonsmentioning

confidence: 94%

Imaging in the Assessment of Musculoskeletal Manifestations Associated with Inflammatory Bowel Disease

Becciolini

Donato

Lucchini

et al. 2021

Gastroenterology Insights

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Extraintestinal manifestations are the cause of morbidity and affect the quality of life of patients with inflammatory bowel diseases (IBDs). Musculoskeletal manifestations, in particular, spondyloarthritis and osteoporosis, are the most frequent extraintestinal manifestation of IBDs. The diagnosis and management of the musculoskeletal manifestation of IBDs relies on imaging. Conventional radiography, magnetic resonance imaging, computed tomography, and ultrasound can help to detect pathological signs of spondyloarthritis, both peripheral and with axial involvement. Dual-energy X-ray absorptiometry is the gold standard for identifying the presence of osteoporosis, whereas conventional radiology and computed tomography can reveal occult vertebral fractures. The aim of this narrative review is to describe the imaging of musculoskeletal manifestations of IBDs.

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Screening for spondyloarthritis in patients with inflammatory bowel diseases

et al. 2022

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Ultrasonographic and clinical assessment of peripheral enthesitis and arthritis in an Italian cohort of inflammatory bowel disease patients

Cited by 14 publications

References 42 publications

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

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

Imaging in the Assessment of Musculoskeletal Manifestations Associated with Inflammatory Bowel Disease

Screening for spondyloarthritis in patients with inflammatory bowel diseases

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