AB1347 ASYMPTOMATIC SACROILIITIS DETECTED BY MAGNETIC RESONANCE ENTEROGRAPHY IN PATIENTS AFFECTED BY CROHN’S DISEASE: PREVALENCE AND ASSOCIATION WITH CLINICAL DATA IN A MULTICENTER STUDY OF ADULT AND PEDIATRIC POPULATION

Abstract

BackgroundMagnetic resonance enterography (MRE) is usually performed in patients with Crohn’s disease (CD) for evaluating small bowel involvement. Inflammatory bowel disease (IBD) mainly affect the gastrointestinal tract, although patients may present extraintestinal manifestations (1). Musculoskeletal symptoms are the most frequent extraintestinal manifestation in IBD, especially in CD. Furthermore, sacroiliitis at imaging occurs in about 6-46% of CD patients and may correlate with axial spondyloarthritis (2,3).ObjectivesThe primary aim of our study was to assess the prevalence of sacroiliitis in adult and pediatric patients affected by CD who performed MRE. We also evaluated the inter-rater agreement for MRE sacroiliitis and the association between sacroiliitis and patients’ clinical data.MethodsWe included consecutive patients with CD diagnosis (4), who underwent an MRE in the period between December 2012 and May 2020. We excluded patients with a known diagnosis of SpA; patients with confirmed or suspected inflammatory back pain; and patients treated at the time of MRE with systemic Disease-Modifying Antirheumatic Drugs (DMARDs), which influence both bowel and joint disease (i.e., conventional DMARDs, and biologic DMARDs).Two radiologists assessed the prevalence of sacroiliitis at MRE. We evaluated the inter-rater agreement for sacroiliitis and assessed the correlation between sacroiliitis and demographic, clinical, and endoscopic data.ResultsWe retrospectively identified 100 adult and 30 pediatric patients. The prevalence of sacroiliitis at MRE was 20% in adults and 6.7% in pediatric patients. The inter-rater agreement for sacroiliitis was substantial (k=0.62, p<0.001) in the adults, and moderate (k=0.46, p=0.011) in the pediatric cohort. Age ≥50 years and the time between CD diagnosis and MRE (≥86.5 months) were significantly associated with sacroiliitis in adult patients (p=0.049 and p=0.038, respectively).ConclusionAsymptomatic sacroiliitis at MRE is a frequent and reliable abnormality in adult patients with CD, associated with age of the patients ≥ 50 years and CD duration. Detecting sacroiliitis at MRE in patients affected by CD may help the appropriate and early referral to the rheumatologist.