Keskin Onur, Farisogullari Bayram, Yardimci Gozde Kubra, Gurbuz Burcu, Kole Melike, Parlak Erkan, Karadag Omer, Kav Taylan, Kalyoncu Umut
Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Türkiye.
Department of Rheumatology, Hacettepe University School of Medicine, Ankara, Türkiye.
Front Med (Lausanne). 2023 Feb 9;10:1115362. doi: 10.3389/fmed.2023.1115362. eCollection 2023.
This study aimed to determine the effectiveness of adding a simple questionnaire related to musculoskeletal system to routine outpatient examination to detect undiagnosed axial and peripheral arthropathy in patients with inflammatory bowel disease (IBD).
A musculoskeletal symptom questionnaire was given to all patients with IBD during their follow-up examinations between January 2020 and November 2021. The DETAIL questionnaire consisting of six questions about the musculoskeletal system was administered by asking the patients with IBD. All patients who answered yes to at least one of these questions were directed to specialists in the rheumatology department to undergo a detailed examination. The patients who were diagnosed with rheumatological disease after further investigation were recorded. Patients with a known diagnosis of rheumatological disease were excluded from the study.
There were 333 patients with IBD included in the study. Of these patients, 41 (12.3%) had a previously diagnosed rheumatological disease and were excluded from the evaluation. Of the remaining 292 patients (147 with ulcerative colitis, 139 with Crohn's disease and six with indeterminate colitis; mean age 42 years), 67 (23%) answered yes to at least one of the questions and were referred to a rheumatology consultation. Rheumatological examination was completed in 52 patients. As a result of the evaluations, 24 patients (8.2%) were diagnosed with enteropathic arthritis (14 axial, 9 peripheral, and 1 axial plus peripheral). Patients with newly diagnosed enteropathy had a lower median disease age than patients without enteropathy.
The DETAIL questionnaire is an effective and easy tool for identifying missed cases of SpA in patients with IBD.
本研究旨在确定在常规门诊检查中增加一份与肌肉骨骼系统相关的简单问卷，以检测炎症性肠病（IBD）患者中未被诊断出的轴性和外周关节病的有效性。
在2020年1月至2021年11月的随访检查期间，向所有IBD患者发放了一份肌肉骨骼症状问卷。由IBD患者回答一份由六个关于肌肉骨骼系统问题组成的DETAIL问卷。对这些问题中至少一个回答为“是”的所有患者被转介至风湿科专家处进行详细检查。记录经进一步检查后被诊断为风湿性疾病的患者。已知诊断为风湿性疾病的患者被排除在研究之外。
本研究纳入了333例IBD患者。其中，41例（12.3%）之前被诊断患有风湿性疾病并被排除在评估之外。在其余292例患者（147例溃疡性结肠炎、139例克罗恩病和6例不确定性结肠炎；平均年龄42岁）中，67例（23%）对至少一个问题回答为“是”并被转介至风湿科会诊。52例患者完成了风湿科检查。评估结果显示，24例患者（8.2%）被诊断为肠病性关节炎（14例轴性、9例外周性和1例轴性加外周性）。新诊断为肠病的患者的疾病中位年龄低于未患肠病的患者。
DETAIL问卷是识别IBD患者中脊柱关节炎漏诊病例的有效且简便的工具。
