SAT0662 Screening research of ultrasonographic peripheral arthritis and enthesitis in patients with inflammatory bowel disease

Background Some patients with inflammatory bowel diseases (IBD) such as ulcerative colitis (UC) and Crohn’s disease (CD) develop spondyloarthritis (SpA). Conventionally, the assessment of affected joint count in patients with SpA was relied for the detection of swelling and tenderness in the joints and enthesis by clinical physical examination. To date, high quality ultrasonography (US) can detect inxammatry condition in the joint and enthesis more sensitively than clinical assessment. Objectives The aim of this study was to research the utility of US screening for detection of peripheral arthritis in patients with IBD. Methods Total 42 patients including 27 patients with UC and 15 patients with CD were consecutively included. HI VISION Ascendus (Hitachi Aloka Medical, Tokyo, Japan) was used with an 18 MHz linear array transducer. US examination was performed in MCP, PIP, DIP and wrist joints in both hand. Greyscale (GS) and power Doppler (PD) US were scored on a 0–3 semi quantitative scale for each joint. Moreover, the US assessment of enthesis was performed. Lateral epicondyle, triceps enthesis, the proximal and distal patella tendon enthesis, Achilles tendon and fascia plantaris tendon enthesis was scanned in both GS and PD assessment. Abnormal findings of enthesis was defined structure, thickness, bursitis, erosion, calcification in GS and power Doppler signal. Results In the joint clinical assessment, 12 patients with UC and 7 patients with CD had joint symptoms. US active synovitis (GS Grade≥2 · PD Grade≥1) was found in 8 patients with UC and 6 patients with CD. The concordance rate between clinical findings and US findings was relatively low in UC and high in CD patients. In the enthesial clinical assessment, 9 patients with UC and 7 patients with CD had tenderness in any enthesis. Active enthesitis in US was found in 16 patients with UC and 8 patients with CD. The concordance rate between clinical findings and US findings was relatively high and subclinical enthesitis was also found in many patients. Conclusions The peripheral arthritis and enthesitis findings in patients with IBD was compared between clinical and US examination. The prevalance rate of subclinical synovitis was not high, thus US screening might not be useful in patients with IBD without arthritis symptom. However, the subclinical enthesitis was found in patients without any enthesial symptoms. US screening might be useful to detect subclinical enthesitis than clinical examination in patients with IBD. Reference [1] Eshed I, Hermann KG. Novel imaging modalities in spondyloarthritis. Curr Opin Rheumatol2015;27:333–42. Disclosure of Interest None declared