1
|
Kim DK, Lee KC, Kim JK. Sacroiliitis in inflammatory bowel disease on abdominal computed tomography: prevalence, misses, and associated factors. Scand J Rheumatol 2024; 53:248-254. [PMID: 38686835 DOI: 10.1080/03009742.2024.2337453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/28/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE To evaluate the prevalence and rate of a missed diagnosis of sacroiliitis on abdominal computed tomography (CT) in patients with inflammatory bowel disease (IBD). Factors associated with sacroiliitis were also assessed. METHOD This retrospective study included 210 patients with IBD (mean age 31.1 years) who underwent abdominal CT. Based on a validated abdominal CT scoring tool, bilateral sacroiliac (SI) joints on abdominal CT in the whole study population were retrospectively reviewed. Subsequently, patients were classified into the 'patients with sacroiliitis' group and the 'patients without sacroiliitis' group. Univariate and multivariate regression analyses were used to clarify the factors associated with sacroiliitis. RESULTS Sacroiliitis was identified in 26 out of 210 patients (12.4%). However, sacroiliitis was recognized on the primary reading in only five of these 26 patients (19.2%) and was missed on the initial report in the remaining 21 patients (80.8%). Among the 21 patients, 20 (95.2%) were finally diagnosed with axial spondyloarthritis (axSpA). There was a higher prevalence of female sex (p = 0.04), upper gastrointestinal involvement (p = 0.04), and back pain (p < 0.01) in patients with sacroiliitis than in those without sacroiliitis. However, on multivariate analysis, back pain was the only factor associated with sacroiliitis (p = 0.01). CONCLUSION Physicians should carefully evaluate SI joints on abdominal CT in patients with IBD to enable early detection of sacroiliitis, potentially leading to an early diagnosis of axSpA. In addition, if patients with IBD present with back pain, the possibility of sacroiliitis should be considered.
Collapse
Affiliation(s)
- D K Kim
- Department of Radiology, The Armed Forces Capital Hospital, Seongnam, Republic of Korea
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - K-C Lee
- Department of Radiology, The Armed Forces Capital Hospital, Seongnam, Republic of Korea
- Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - J K Kim
- Department of Radiology, The Armed Forces Capital Hospital, Seongnam, Republic of Korea
| |
Collapse
|
2
|
Lee JW, Eun CS. Inflammatory bowel disease in Korea: epidemiology and pathophysiology. Korean J Intern Med 2022; 37:885-894. [PMID: 35902371 PMCID: PMC9449206 DOI: 10.3904/kjim.2022.138] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 05/02/2022] [Indexed: 11/27/2022] Open
Abstract
Inflammatory bowel disease (IBD) refers to a group of disorders, including Crohn's disease and ulcerative colitis, that exhibit similar but distinct manifestations. These diseases are characterized by refractory and chronic inflammation of the bowel. IBD is usually accompanied by severe symptoms. When a patient presents with suspected IBD, physicians encounter various challenges in terms of diagnosis and treatment. In addition, given such characteristics, the associated medical expenses gradually increase. Although IBD was formerly known as a disease of Western countries, the incidence and prevalence are increasing in Korea. Korean investigators have accumulated a great deal of knowledge about the regional characteristics and epidemiology of the disease, especially via well-organized, joint cohort studies. Against this background, this article describes the epidemiology of IBD in Korea compared to that in the West. In addition, an overview of the pathophysiology of the disease is provided, focusing on the latest results.
Collapse
Affiliation(s)
- Jung Won Lee
- Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon,
Korea
| | - Chang Soo Eun
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri,
Korea
| |
Collapse
|
3
|
Gomollón F, Seoane-Mato D, Montoro MA, Juanola X, Trujillo-Martin E, Carrillo-Palau M, Matallana V, García-Magallón B, Ber Y, Ramos L, Perez-Pampin E, Ferreiro-Iglesias R, Rodríguez-Alonso L, Marco-Pascual C, Sanz Sanz J. Validation of screening criteria for spondyloarthritis in patients with inflammatory bowel disease in routine clinical practice. Dig Liver Dis 2022; 54:755-762. [PMID: 35039222 DOI: 10.1016/j.dld.2021.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/07/2021] [Accepted: 12/14/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Spondyloarthritis (SpA) is one of the most common extraintestinal manifestations of inflammatory bowel disease (IBD). Diagnostic delay must be avoided. AIMS We assessed the validity of SpA screening criteria (any of the following characteristics: chronic low back pain with onset before 45 years of age; inflammatory lower back pain or alternating buttock pain; arthritis; heel enthesitis; dacylitis; HLA-B27 positivity; sacroiliitis on imaging). METHODS This was a multicenter cross-sectional observational study in IBD patients aged ≥18 years. After evaluating the SpA screening criteria, the gastroenterologists referred the participants to the rheumatologists, who determined whether the patient fulfilled the screening criteria and carried out the necessary tests for SpA diagnosis. RESULTS 35 (11.7%) out of 300 patients were diagnosed with SpA. The combination with the best balance between sensitivity and specificity (91.4% and 72.1%, respectively, when applied by the rheumatologists; 80% and 78.9%, when applied by the gastroenterologists) for SpA screening, was fulfillment of any of the following: chronic low back pain with onset before age 45 years, inflammatory low back pain or alternating buttock pain, arthritis, or dactylitis. CONCLUSION This is one of the first studies to validate SpA screening criteria in IBD patients in routine clinical practice.
Collapse
Affiliation(s)
- Fernando Gomollón
- Medical School, University of Zaragoza, IIS Aragón, CIBEREHD, Zaragoza, Spain.
| | | | - Miguel A Montoro
- Unit of Gastroenterology, Hepatology and Nutrition, Hospital General San Jorge, Huesca, Spain
| | - Xavier Juanola
- Department of Rheumatology, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Elisa Trujillo-Martin
- Department of Rheumatology, Hospital Universitario de Canarias, Sta. Cruz de Tenerife, Spain
| | - Marta Carrillo-Palau
- Department of Gastroenterology, Hospital Universitario de Canarias, Sta. Cruz de Tenerife, Spain
| | - Virginia Matallana
- Department of Gastroenterology, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | | | - Yolanda Ber
- Unit of Gastroenterology, Hepatology and Nutrition, Hospital General San Jorge, Huesca, Spain
| | - Laura Ramos
- Department of Gastroenterology, Hospital Universitario de Canarias, Sta. Cruz de Tenerife, Spain
| | - Eva Perez-Pampin
- Department of Rheumatology, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, A Coruña, Spain
| | - Rocío Ferreiro-Iglesias
- Department of Gastroenterology, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, A Coruña, Spain
| | - Lorena Rodríguez-Alonso
- Department of Gastroenterology and Hepatology, Hospital Universitari de Bellvitge- IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Carla Marco-Pascual
- Department of Rheumatology, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Jesús Sanz Sanz
- Department of Rheumatology, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain.
| | | |
Collapse
|