P260 Clinical-ultrasound comparison of enthesis lesions in inflammatory bowel diseases

Abstract

Abstract Background The objective of study was to compare the frequency of enthesis lesions in pts with inflammatory bowel diseases (IBD) according to clinical examination and ultrasound (US). Methods 95 IBD pts were prospectively enrolled into the study: 55 pts with ulcerative colitis and 40 - with Crohn's disease. The average age of pts was 32 (26; 37) years. The average duration of the disease was 48 (12; 96) months. During clinical examination, palpation tenderness of 46 enthesis of the upper and lower extremities was assessed in each pt. According to the results of the evaluation, the number of painful entheses was calculated. US examination with power Doppler detected inflammatory (hypoechogenicity of enthesis, thickening of enthesis, presence of vascularization) and structural (erosion, enthesophyte) changes in entheses. US examination included 68 entheses of the upper and lower extremities in each pt. Results A total of 4370 entheses were examined clinically. Pain on palpation of entheses was noted in 49 pts (52%). The number of painful entheses was 149 (3.4%). A total of 6460 entheses were examined using US. Enthesites were found in 72 pts (76%), including vascularized enthesites in 35 pts (37%). The total number of identified enthesites was 293/6460 (4.5%), enthesites with vascularization - 62/6460 (1.0%). Structural changes in entheses were common. Erosions were determined in 76 pts (80%), the total number of enthesis erosions was 313/6460 (4.8%). Enthesophytes were detected in 37 pts (39%), the total number of enthesophytes was 91/6460 (1.4%). The number of enthesites detected by US - 72 pts (76%) significantly exceeded the number of clinically painful entheses on palpation - 49 pts (52%) (p=0.0008). Conclusion In pts with IBD, according to US, the frequency of detection of enthesis lesions - 72 pts (76%) was significantly higher than in clinical examination - 49 pts (52%).