AB0728 PREVALENCE AND SEVERITY OF CLINICAL AND IMAGING AXIAL SPONDYLOARTHRITIS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Abstract

Background Some patients with inflammatory bowel disease (IBD), such as ulcerative colitis (UC) and Crohn’s disease (CD), develop spondyloarthritis (SpA). Inflammatory back pain (IBP) is one of the most important signs of axial SpA. However, changes in conventional radiography take a long time to appear as typical changes, such as erosion, sclerosis, or ankylosis. Magnetic resonance imaging (MRI) is useful for assessing axial involvement. High-quality imaging modalities can detect the inflammatory condition in the joints and enthesis more sensitively than clinical assessment or conventional radiography. Objectives This study aimed to examine the clinical and imaging prevalence or severity of axial SpA in patients with IBD. Methods A total of 56 patients, including 39 with UC (19 males, 20 females) and 17 with CD (10 males, 7 females) were included. The assessment of SpondyloArthritis international Society (ASAS) Expert Criteria were used to assess IBP. The criteria were fulfilled if at least four of five of the following questions were answered by “yes”: (1) did your back pain start when you were aged 40 or younger?; (2) did your back pain develop gradually?; (3) does your back pain improve with exercise?; (4) do you find that there is no improvement in your back pain when you rest?; and (5) do you suffer from back pain at night, which improves upon getting up? Image evaluation was performed blindly by two readers. Conventional radiography was evaluated by the modified Stoke aS Spine Score (mSASSS) in the spine and the Grade of modified New York criteria (mNY) in the sacroiliac joints. In MRI, spinal and sacroiliac joints were evaluated by the Spondylo-arthritis Research Consortium of Canada (SPARCC) score. Results Among the 56 patients with IBD, 21 had IBP by clinical examination and 11 had pain in the sacroiliac joints. In conventional radiography, the average mSASSS score was 8.9 in patients with IBP and 6.5 in patients without IBP (p = 0.257). Eleven patients had bilateral Grade 2 or unilateral Grade 3 of the mNY, and three (27.3%) of these patients had sacroiliac pain and eight (17.8%) did not have sacroiliac pain (p = 0.477). In spine MRI, nine (42.9%) patients with IBP and nine (25.7%) patients without IBP had an SPARCC score of > 2 (p = 0.184). In sacroiliac MRI, one (9.1%) patient with sacroiliac pain and 12 (26.7%) patients without sacroiliac pain had an SPARCC score of > 2 (p = 0.216). Conclusion Even without clinical symptoms of SpA, significant inflammatory findings are detected by MRI. Imaging might be important, regardless of the presence or absence of clinical symptoms, in patients with IBD.