G.R. GAINULLINA¹, E.R. KIRILLOVA^1, 2, A.KH. ODINTSOVA², N.A. CHEREMINA², L.R. SADYKOVA², A.YU. KHASANSHINA², D.I. ABDULGANIEVA^1, 2

 ¹Kazan State Medical University of the Ministry of Health of the Russian Federation, Kazan, Russia

²Republic Clinical Hospital, Kazan

  Contact details:

Gainullina G.R. — post-graduate student of the Department of Hospital Therapy

Address: 49 Butlerov St., Kazan, Russian Federation, 420012, tel.: +7 (843) 237-34-83, e-mail: nice.gaynullina@bk.ru

The purpose — to assess the lesions of joints and periarticular tissues in patients with inflammatory bowel diseases (IBD) and their correlation with IBD course.

Material and methods. The research included 50 patients with IBD. Clinical and ultrasound examinations of peripheral joints and sinew and ligaments entheses in the joint projections were performed. Analysis of the correlation between the clinical characteristics of IBD (course and duration of the disease) and signs of joint and entheses damage (joint pain, number of tender entheses, synovitis, enthesitis, LEI, MASES, SPARCC, GUESS, MASEI, BUSES indices) was performed with Spearman criteria.

Results. IBD duration had a direct correlation with the presence of joint pain (SR = 0.58; р = 0,0006), number of tender entheses (SR = 0,47; р = 0,008), and number of enthesitis (SR = 0,4; р = 0,002). The disease duration also directly correlated with the GUESS (SR = 0,38; р = 0,034). There was no statistically significant relationship between the attack severity and the damage to the joints and entheses.

Conclusion. The frequency of joint and periarticular tissues damage (pain, tender enthuses during palpation, enthesitis without vascularization, ultrasound index of enthuses lesions GUESS) is significantly correlated with the duration of the disease. Manifestations of the joint and periarticular tissues lesions are independent of IBD activity.

Key words: inflammatory bowel diseases; entheseal abnormalities; ultrasound and clinical enthesitis scoring systems.

REFERENCES

1. The First European Evidence-based Consensus on Extra-Intestinal Manifestations in IBD. JCC, 2016, vol. 10 (3), rr. 239–254.
2. Lanna C.C.D, Abreu Ferrari M.D.L., Rocha S.L. et al. A cross-sectional study of 130 Brazilian patients with Crohn’s disease and ulcerative colitis: analysis of articular and ophthalmologic manifestations. Clinical Rheumatol, 2008, vol. 27, rr. 503–509.
3. Orchard T.R., Wordsworth B.P., Jewell D.P. Peripheral arthropathies in inflammatory bowel disease: their articular distribution and natural history. Gut, 1998, vol. 42, rr. 387–391.
4. Salvarani C., Vlachonikolis I.G., van der Heijde D.M. et al. Musculoskeletal manifestations in a population-based cohort of inflammatory bowel disease patients. Scand J Gastroenterol, 2001, vol. 36, rr. 1307–1310.
5. Brakenhoff L.K., van der Heijde D.M., Hommes D.W. et al. The joint-gut axis in inflammatory bowel diseases. Journal of Chron’s and Colitis, 2010, vol. 4, rr. 257–268.
6. McGonagle D., Khan M.A., Marzo-Ortega H. et al. Enthesitis in spondyloarthropathy. Curr Opin Rheumatol, 1999, vol. 11, pp. 244–250.
7. Khan M.A. Enthesitis: a broader definition. Ann Rheum Dis, 2000, vol. 59, pp. 998.
8. Francois R.J., Braun J., Khan M.A. Entheses and enthesitis: a histopathologic review and relevance to spondyloarthritides. Curr Opin Rheumatol, 2001, vol. 13, pp. 255–264.
9. Arvikar S.L., Fisher M.C. Inflammatory bowel disease associated arthropathy. Current Reviews in Musculoskeletal Medicine, 2011, vol. 4, pp. 123–131.
10. Balint P.V., Kane D., Wilson H. et al. Ultrasonography of entheseal insertions in the lower limb in spondyloarthropathy. Ann Rheum Dis, 2002, vol. 61 (10), pp. 905–910.
11. Bandinelli F., Milla M., Genise S. et al. Ultrasound discloses entheseal involvement in inactive and low active inflammatory bowel disease without clinical signs and symptoms of spondyloarthropathy. Rheumatology (Oxford), 2011, vol. 50 (7), rr. 1275–1279.
12. Rovisco J., Duarte C., Batticcioto A. et al. Hidden musculoskeletal involvement in inflammatory bowel disease: a multicenter ultrasound study. BMC Musculoskelet Disord, 2016, vol. 17, p. 84.
13. Schett G., Lories R., D’Agostino M. et al. Enthesitis: from pathophysiology to treatment. Nature Reviews Rheumatology, 2017, vol. 13, pp. 731–741.
14. Ruyssen-Witrand A., Jamard B., Cantagrel A. et al. Relationships between ultrasound enthesitis, disease activity and axial radiographic structural changes in patients with early spondyloarthritis: data from DESIR cohort. Rheumatic and musculoskeletal diseases Open, 2017, vol. 9, pp. 1–8.