Background: joint involvement is the most common extraintestinal manifestation in paediatric IBD patients. Several studies in adult population have shown that enthesis ultrasound (US) has a high sensitivity in the diagnosis of enthesitis. Objectives: The objective is to evaluate, using a high frequency ultrasound probe, the prevalence of subclinical entheseal involvement in paediatric IBD patients. Methods: 27 paediatric IBD patients [12 Crohn's disease, 13 ulcerative colitis and 2 IBD type unclassified; 15 females and 12 males, mean age of 13,7 years (ranging 7,2-21,0 years)] without clinical signs or symptoms of musculo-skeletal involvement were consecutively investigated with US (ESAOTE MyLAB 70 6-18 MHz linear array transducer) and compared with 24 healthy controls matched for age and sex. Twelve enthesis were scored according to the Madrid Sonographic Enthesis Index (MASEI) in both groups. Results: no patients reached the MASEI score value suggestive for an early spondyloarthritis involvement but the average MASEI score was significantly higher in IBD patients compared to controls (3.15±2.84 vs 0.96±1.12, p=0.0006).There was also a significantly higher percentage of patients with at least one enthesis with power Doppler (PD) score ≥2 (37% vs 16%; p= 0.037) and at least one enthesis with dishomogeneous echostructure (59% vs 0%; p= 0.000). No differences were found in terms of erosions, calcifications and structural thickness. In IBD patients, no correlation was found between MASEI total score and sex, age, disease duration and clinical activity scores. Conclusions: US detectable enthesopathy is frequent even in paediatric IBD patients.
Interessamento entesitico in bambini e adolescenti con malattia infiammatoria cronica intestinale: uno studio ecografico / D. Dilillo, A. Batticciotto, M. Nugnes, F. Penagini, F. Meneghin, M. Antivalle, V. Varisco, P.C. Sarzi-Puttini, G.V. Zuccotti. ((Intervento presentato al 21. convegno Dalle linee guida alla pratica clinica tenutosi a Sorrento nel 2014.
Interessamento entesitico in bambini e adolescenti con malattia infiammatoria cronica intestinale: uno studio ecografico
A. Batticciotto;F. Penagini;F. Meneghin;V. Varisco;G.V. Zuccotti
2014
Abstract
Background: joint involvement is the most common extraintestinal manifestation in paediatric IBD patients. Several studies in adult population have shown that enthesis ultrasound (US) has a high sensitivity in the diagnosis of enthesitis. Objectives: The objective is to evaluate, using a high frequency ultrasound probe, the prevalence of subclinical entheseal involvement in paediatric IBD patients. Methods: 27 paediatric IBD patients [12 Crohn's disease, 13 ulcerative colitis and 2 IBD type unclassified; 15 females and 12 males, mean age of 13,7 years (ranging 7,2-21,0 years)] without clinical signs or symptoms of musculo-skeletal involvement were consecutively investigated with US (ESAOTE MyLAB 70 6-18 MHz linear array transducer) and compared with 24 healthy controls matched for age and sex. Twelve enthesis were scored according to the Madrid Sonographic Enthesis Index (MASEI) in both groups. Results: no patients reached the MASEI score value suggestive for an early spondyloarthritis involvement but the average MASEI score was significantly higher in IBD patients compared to controls (3.15±2.84 vs 0.96±1.12, p=0.0006).There was also a significantly higher percentage of patients with at least one enthesis with power Doppler (PD) score ≥2 (37% vs 16%; p= 0.037) and at least one enthesis with dishomogeneous echostructure (59% vs 0%; p= 0.000). No differences were found in terms of erosions, calcifications and structural thickness. In IBD patients, no correlation was found between MASEI total score and sex, age, disease duration and clinical activity scores. Conclusions: US detectable enthesopathy is frequent even in paediatric IBD patients.File | Dimensione | Formato | |
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