Abstract
Background: our aim was to assess frequency of asymptomatic sacroiliitis (SI) in patients with Crohns disease referred for magnetic resonant enterography (MRE) as a part of small bowel evaluation. Methods: this was a retrospective study of all patients with Crohns disease who were referred for MRE between January of 2016 to October of 2017 to Jordan University Hospital. All MRE were reviewed by an experienced radiologist and SI was diagnosed and graded based on predefined MRI criteria. All patients were contacted and assessed for symptomatic SI based on Assessment of SpondyloArthritis international Society (ASAS) criteria of 2009 for axial spondyloarthropathy. All patients were included in the final analysis.Results: a total of 60 patients were included, overall 18 (30%) showed evidence of SI, two patients were symptomatic and another two were diagnosed with ankylosing spondylitis as assessed by ASAS criteria. Those were excluded. Fourteen (23%) patients were included in the final analysis, with an average age of 36.7 years, 71% males. The average disease duration was 7.25 years. The percentage of ASA used by patients was 50%, Azathioprine 71%, Biologic agents in 36% in combination and single drug was used in 36% of patients.Conclusion: The prevalence of asymptomatic SI based on predefined MRI criteria was 23%, the importance of this finding and future course progression needs further studies.
Highlights
Extra-intestinal musculoskeletal manifestations associated with Inflammatory bowel disease (IBD), can be divided into axial and peripheral arthropathy, which can be a cause of significant morbidity that can adversely affect the quality of life in these patients
All patients with SI based on MRI criteria were contacted and assessed for symptomatic SI based on Assessment of SpondyloArthritis international Society (ASAS) criteria of 2009 for axial spondyloarthropathy
There was a total of 60 patients who underwent magnetic resonant enterography (MRE) with a final diagnosis of Crohn’s disease, overall 18 (30%) showed signs of joint inflammation on MRI. of those two patients were symptomatic and another two were diagnosed with ankylosing spondylitis as assessed by ASAS criteria (Sieper et al, 2009)
Summary
Extra-intestinal musculoskeletal manifestations associated with Inflammatory bowel disease (IBD), can be divided into axial and peripheral arthropathy, which can be a cause of significant morbidity that can adversely affect the quality of life in these patients. Peripheral arthropathy represent the most frequent (40%) extra-intestinal manifestation in IBD (Gravallese & Kantrowitz, 1988; Vavricka, Schoepfer, Scharl, Lakatos, Navarini, & Rogler, 2015). These manifestations occur more frequently in patients with Crohn’s disease (CD) (Veloso, Carvalho, & Magro, 1996). The diagnosis is based upon the presence of characteristic inflammatory type back pain with evidence of SI on imaging (Sieper et al, 2009). Both clinical examination and plain radiographs have their own limitations of only detecting advanced disease. The aim of this study is to assess the frequency of asymptomatic sacroiliitis in Jordanian Crohn’s patients based on predefined MRI criteria
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