P135 Usefulness of clinical and ultrasound indices to assess enthesis lesions in patients with inflammatory bowel diseases

Abstract

Abstract Background The aim of the study was to assess existing clinical and ultrasound indices for the evaluation of enthesopathies in patients with inflammatory bowel diseases (IBD). Methods 95 pts with IBD were prospectively enrolled into the study: 55 of them with ulcerative colitis (UC) and 40 with Crohn’s disease (CD). Clinically we counted tender entheses in 46 points of the upper and lower extremities. LEI (Leeds Enthestis Index) (0–6 points), MASES (Maastricht Ankylosing Spondylitis Enthesitis Score) (0–13 points) and the SPARCC index (Spondylarthritis Research Consortium of Canada) (0–16 points) were calculated. Ultrasound examination was performed in B-mode and PD-mode. Entheseal hypoechogenicity, entheseal thickening, presence of vascularization were considered as acute lesions. Bone erosions and enthesophytes were considered as chronic lesions. GUESS (Glasgow Ultrasound Enthesitis Scoring System) (0–36 points), MASEI (Madrid Sonography Enthesitis Index) (0–136 points) and BUSES (Belgrade Ultrasound Enthesitis Score) (0–132 points) were calculated. Spearman coefficient used to calculate correlations. Results In pts with tender ≥ 1 enthesis, the LEI was positive in 26% of patients, the MASES index - in 7%, the SPARCC index - in 18%, the US indices were positive in a larger number of patients: GUESS - in 47%, MASEI - in 40% and BUSES - 54%.A total of 6460 entheses were examined using Doppler ultrasound. The number of enthesites was 293/6460 (4.5%), the number of enthesites with vascularization was 62/6460 (1.0%), the number of erosions was 313/6460 (4.8%), the number of enthesophytes was 91/6460 (1, 4%).A direct correlation is observed between the number of enthesites and LEI indices (SR = 0.54; p = 0.00), MASES (SR = 0.42; p = 0.00), SPARCC (SR = 0.54; p = 0, 00), GUESS (SR = 0.22; p = 0.02), BUSES (SR = 0.32; p = 0.001), as well as between the number of enthesitis with vascularization and LEI indices (SR = 0.24; p = 0.017), MASES (SR = 0.34; p = 0.00), GUESS (SR = 0.23; p = 0.022), MASEI (SR = 0.32; p = 0.001), BUSES (SR = 0, 29; p = 0.003). A statistically significant relationship was found between the number of erosion and the GUESS indices (SR = 0.48; p = 0.00), MASEI (SR = 0.49; p = 0.00), BUSES (SR = 0.5; p = 0, 00), as well as between the number of enthesophytes and the GUESS indices (SR = 0.75; p = 0.00), MASEI (SR = 0.28; p = 0.00), BUSES (SR = 0.57; p = 0.00). Conclusion Acute lesion of enthesis in patients with IBD can be assessed using both clinical (LEI, MASES, SPARCC) and ultrasound indices (GUESS, MASEI, BUSES). To assess chronic lesions (erosion, enthesophyte) changes in enthesis in patients with IBD, it is preferable to use ultrasound indices.