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Tavassoli S, Shahabinasab I, Norouzi A, Amiriani T, Abdolahi N, Livani S, Mirkamali SF, Mirkarimi HS, Amlashi FI, Besharat S. From bowel inflammation to the bone and joints: musculoskeletal examination in inflammatory bowel disease (IBD). BMC Musculoskelet Disord 2021; 22:1019. [PMID: 34863148 PMCID: PMC8645134 DOI: 10.1186/s12891-021-04903-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 11/24/2021] [Indexed: 11/10/2022] Open
Abstract
Background One of the most important complications in inflammatory Bowel Disease (IBD) are musculoskeletal manifestations that are reported in more than 50% of patients. Objectives In this study, we aimed to evaluate the musculoskeletal and radiologic manifestations in our IBD patients. Methods In this cross-sectional study on 96 mild-to-moderate IBD patients (76 UC, 18 CD and 2 undifferentiated IBD) with mean (SD) age of 39.28 (11.42) years, 44 (45.8%) were males and 52 were (54.2%) females. Patients were examined by an expert rheumatologist and their musculoskeletal symptoms were assessed. The musculoskeletal system was evaluated by Modified Schober test, Thoracic expansion (TE), Occiput to wall distance (OWD), and Patrick’s or FABER test. Peripheral joints were also examined in all four extremities. Then patients were referred for pelvic and lumbosacral x-ray. Sacroiliitis grading was performed using the New York criteria. Results Inflammatory low back pain was reported in 5 (5.2%), enthesopathy in 6 (6.5%) and dactylitis in 1 (1.1%). Positive Schober test was recorded in 5 (5.2%) and Patrick test in 3 (3.1%). Forty-nine (51%) cases had normal imaging with no sacroiliitis, endplate sclerosis was seen in 33 cases (34.4%), grade 3 and grade 4 were seen in 10 cases (10.4%). Conclusions In the present study, 34.4% of the IBD patients had mild radiologic changes as endplate sclerosis and 95% had a normal physical examination.
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Affiliation(s)
- Samane Tavassoli
- Golestan Rheumatology Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Iman Shahabinasab
- Golestan Research Center of Gastroenterology and Hepatology, GolestanUniversity of Medical Sciences, 3rd floor, Heart Complex, Sayyad-e-Shirazi Hospital, Sayyad-e-Shirazi Boulevard, Gorgan city, Golestan province, Iran
| | - Alireza Norouzi
- Golestan Research Center of Gastroenterology and Hepatology, GolestanUniversity of Medical Sciences, 3rd floor, Heart Complex, Sayyad-e-Shirazi Hospital, Sayyad-e-Shirazi Boulevard, Gorgan city, Golestan province, Iran
| | - Taghi Amiriani
- Golestan Research Center of Gastroenterology and Hepatology, GolestanUniversity of Medical Sciences, 3rd floor, Heart Complex, Sayyad-e-Shirazi Hospital, Sayyad-e-Shirazi Boulevard, Gorgan city, Golestan province, Iran
| | - Nafiseh Abdolahi
- Golestan Rheumatology Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Somayeh Livani
- Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - Seyed Farzam Mirkamali
- Golestan Research Center of Gastroenterology and Hepatology, GolestanUniversity of Medical Sciences, 3rd floor, Heart Complex, Sayyad-e-Shirazi Hospital, Sayyad-e-Shirazi Boulevard, Gorgan city, Golestan province, Iran
| | - Honey Sadat Mirkarimi
- Golestan Research Center of Gastroenterology and Hepatology, GolestanUniversity of Medical Sciences, 3rd floor, Heart Complex, Sayyad-e-Shirazi Hospital, Sayyad-e-Shirazi Boulevard, Gorgan city, Golestan province, Iran
| | - Fazel Isapanah Amlashi
- Golestan Research Center of Gastroenterology and Hepatology, GolestanUniversity of Medical Sciences, 3rd floor, Heart Complex, Sayyad-e-Shirazi Hospital, Sayyad-e-Shirazi Boulevard, Gorgan city, Golestan province, Iran
| | - Sima Besharat
- Golestan Research Center of Gastroenterology and Hepatology, GolestanUniversity of Medical Sciences, 3rd floor, Heart Complex, Sayyad-e-Shirazi Hospital, Sayyad-e-Shirazi Boulevard, Gorgan city, Golestan province, Iran.
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Amiriani T, Besharat S, Pourramezan Z, Mirkarimi HS, Aghaei M, Joshaghani H, Roshandel G, Faghani M, Besharat M. Correlation between low bone density and disease activity in patients with ulcerative colitis. Middle East J Dig Dis 2015; 7:25-30. [PMID: 25628850 PMCID: PMC4293797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 12/11/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Different clinical and epidemiological studies using dual-energy X-ray absorptiometry have shown an increased prevalence of low bone mineral density in patients with inflammatory bowel diseases. The aim of this study was to assess the correlation between bone density and the disease activity in patients with ulcerative colitis. METHODS In this cross-sectional study, 52 patients with ulcerative colitis (duration of the disease less than 5 years) were invited to our research center, Golestan province, northeast of Iran, during February 2012 up to August 2012. A demographic checklist and Simple Clinical Colitis Activity Index was completed for each patients and 5 cc of blood sample was taken after obtaining the informed consent. We used colorimetry method for measuring serum calcium, UV method for serum phosphorus and ELISA for serum vitamin D. Dual-energy X-ray absorptiometry was done to evaluate the bone density. Data analysis was done using SPSS software version 16. Normality of data was assessed using Kolmogorov- Smirnov test. T and ANOVA tests were used if data had normal distribution. Mann-Whitney U or Kruskal-Wallis tests were used for the remaining data. Correlation between qualitative variables was evaluated by Chi-square test. RESULTS The mean (±SD) age and disease activity of the patients were 37.72 (±12.18) years and 4.78 (±1.98), respectively. There were no correlation between disease activity and mean age. Low bone density was seen in 30.8%, 11.5%, and 15.4% in spine, femur neck, and hip, respectively. There was no relationship between Z-score of total hip, spine, and femur neck with disease activity, age, and duration of disease (p>0.05). CONCLUSION Our results showed an acceptable rate of low bone density in patients with ulcerative colitis without any correlation with the disease activity index.
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Affiliation(s)
- Taghi Amiriani
- 1. Assistant Professor, Golestan University of Medical Sciences, Golestan Research Center of Gastroenterology and Hepatology, Gorgan, Iran
| | - Sima Besharat
- 2. Digestive Disease Research Institute, Tehran University of Medical Sciences, Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Iran
| | - Zahra Pourramezan
- 3. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Honey Sadat Mirkarimi
- 3. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mehrdad Aghaei
- 4. Bone, Joint and Connective Tissue Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Hamidreza Joshaghani
- 3. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Gholamreza Roshandel
- 2. Digestive Disease Research Institute, Tehran University of Medical Sciences, Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Iran
| | - Maryam Faghani
- 3. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mahsa Besharat
- 3. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
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