Low Back Pain and Sacroiliitis on Cross-Sectional Abdominal Imaging for Axial Spondyloarthritis Diagnosis in Inflammatory Bowel Diseases

• Published in: Inflammatory intestinal diseases Vol. 5; no. 3; pp. 124 - 131
• Main Authors: Fauny, Marine, Cohen, Nicolas, Morizot, Caroline, Leclerc-Jacob, Sophie, Wendling, Daniel, Lux, Guillaume, Laurent, Valérie, Blum, Alain, Netter, Patrick, Baumann, Cédric, Chary-Valckenaere, Isabelle, Peyrin-Biroulet, Laurent, Loeuille, Damien
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01-08-2020; Karger Publishers
• Subjects: Bioengineering; Human health and pathology; Hépatology and Gastroenterology; imagery; Imaging; inflammatory bowel disease; Life Sciences; Research Article; Rhumatology and musculoskeletal system; sacroiliitis; spondyloarthritis; Inflammatory bowel disease; Sacroiliitis; Imagery; Spondyloarthritis
• ISSN: 2296-9403; 2296-9365
• DOI: 10.1159/000507930

Background: Joint damage is the most frequent extraintestinal manifestation in inflammatory bowel disease (IBD). Aims: The aim of the study was to assess the value of low back pain (LBP) associated with sacroiliitis on abdominal imaging for the diagnosis of spondyloarthritis (SpA) in IBD. Methods: We used a questionnaire assessing rheumatological symptoms for all patients with abdominal computed tomography (CT) and magnetic resonance enterography (MRE). Sacroiliitis was assessed on available CT and MRE. Patients were classified as axial SpA according to the Assessment of SpondyloArthritis International Society criteria. Results: Fifty-one patients completed the questionnaire and performed both exams. LBP was present in 27 patients (52.9%), and 10 (19.6%) had an inflammatory component. Sacroiliitis was reported in 12 patients (23.5%), and 6 of them suffered from LBP. Among the 20 patients referred to the rheumatologist, 11 patients suffered from LBP. One patient was HLA-B27 positive and presented sacroiliitis. For the last 10 patients, none of them had a sacroiliitis, and 2 patients were negative for HLA-B27. Conclusion: An axial SpA has been diagnosed in 11.8% of IBD patients undergoing cross-sectional imaging, whereas one-fifth had inflammatory LBP, and sacroiliitis was observed in one-quarter of them. To optimize the diagnosis of axial SpA, HLA-B27 testing might be required for patients with both IBD and LBP, but this will require further investigation before its implementation in routine practice.