P495 Comparative characteristics of joint damage and entheses of the upper and lower extremities in patients with inflammatory bowel diseases

Abstract

Abstract Background The aim of study was to compare the incidence of joint damage and entheses of the upper and lower extremities in patients with inflammatory bowel diseases (IBD). 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. Using ultrasound, each pt was examined 14 joints and 68 enthesis of the upper and lower extremities. The vascularization was detected in the power Doppler mode. The presence of synovitis was established by detecting the proliferation of the synovial membrane and/or effusion in the joint cavity. Inflammatory (enthesis hypoechogenicity, enthesis thickening, presence of vascularity) changes in enthesis were also performed by ultrasound imaging. Results According to the results of ultrasound of the joints, synovites were detected in 41 pts (43%), including synovites with vascularization in 29 pts (31%). Synovites were most often detected in the ankle joints - in 28 pts (29%). Synovites with vascularization were most often detected in the elbow joints - in 11 pts (12%), in the wrist joints - in 11 pts (12%), in the knee joints - in 10 pts (11%). When comparing the incidence of lesions of the joints of the upper and lower extremities, it was found that synovites were more often observed in the joints of the lower extremities - in 42 pts (44%) than in the upper extremities - in 33 pts (35%). However, differences did not reach statistical significance (p=0.23). Enthesites were found in 72 pts (76%), including vascularized enthesites in 35 pts (37%). The most common enthesites were pes anserinus enthesitis in 42 pts (44%) and medial collateral ligament of the knee joint in 37 pts (39%). The most common enthesitis with vascularization was medial collateral ligament of the knee joint - in 24 pts (25%). Comparing the incidence of enthesis lesions of the upper and lower extremities, it was found that enthesites and enthesites with vascularization were significantly more often observed in the lower extremities (p=0.00, p=0.0001, respectively). Conclusion Pts with IBD had a higher incidence of lower extremity joint involvement, although the differences did not reach statistical significance. Entheses were significantly more often affected in the lower extremities.