Rheumatology Division, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain.
Gastroenterology Division, IBD Unit, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain.
Biomed Res Int. 2018 May 8;2018:8618703. doi: 10.1155/2018/8618703. eCollection 2018.
Musculoskeletal symptoms are the most common extraintestinal manifestations of inflammatory bowel disease (IBD). An essential step in the management of these patients is to establish referral algorithms through the use of appropriate screening tools. Our objective was to evaluate the performance of two simple questionnaires to detect inflammatory arthritis (IA) in patients with IBD. Two questionnaires, one for detecting axial IA and the other for peripheral IA, were tested among 112 IBD unselected consecutive patients of both sexes, aged 18-45 years. The study period was from January to December 2016. Each questionnaire was composed of three simple questions. If the patient answered affirmatively at least to two of the three questions, the questionnaire was considered positive. Clinical diagnosis of IA based on an expert's opinion was the reference gold standard. To obtain a weighted value of sensitivity and specificity, likelihood ratio (LR) values were calculated. Twenty-seven percent of the patients were considered positive responders to the axial questionnaire while 32% were considered positive responders to the peripheral questionnaire. Twenty-four patients (21.4%) were diagnosed with axial IA, whereas 26% had peripheral IA. The axial questionnaire yielded a sensitivity of 87.5% (67.6-97.3), specificity of 89.8% (81.5-92.2) and LR+ of 8.6 (4.5-16.2). For the peripheral questionnaire, these values were 82.8% (64.2-94.2), 87.4% (79-93.3), and 6.6 (3.8-11.4), respectively. Both questionnaires showed an adequate screening capacity for IA in patients with IBD. Their specificity, together with their simplicity, can make them suitable detection tools in gastroenterology and general medicine consultations.
肌肉骨骼症状是炎症性肠病(IBD)最常见的肠道外表现。管理这些患者的重要步骤是通过使用适当的筛选工具建立转诊算法。我们的目的是评估两种简单问卷在检测 IBD 患者炎症性关节炎(IA)中的表现。对 112 例男女未选择的 IBD 连续患者进行了两种问卷的测试,年龄为 18-45 岁。研究期间为 2016 年 1 月至 12 月。每个问卷由三个简单的问题组成。如果患者对三个问题中的至少两个回答肯定,则认为问卷为阳性。基于专家意见的 IA 临床诊断是参考金标准。为了获得灵敏度和特异性的加权值,计算了似然比(LR)值。27%的患者对轴向问卷呈阳性反应,而 32%的患者对周围问卷呈阳性反应。24 例患者(21.4%)被诊断为轴向 IA,而 26%的患者患有周围性 IA。轴向问卷的灵敏度为 87.5%(67.6-97.3),特异性为 89.8%(81.5-92.2),LR+为 8.6(4.5-16.2)。对于外周问卷,这些值分别为 82.8%(64.2-94.2)、87.4%(79-93.3)和 6.6(3.8-11.4)。两种问卷均显示出对 IBD 患者 IA 的良好筛查能力。它们的特异性,以及其简单性,使其成为胃肠病学和普通医学咨询中合适的检测工具。