Point-of-care ultrasound provides useful information in children with Crohn's disease visiting the outpatient clinic.

OBJECTIVES

Point-of-care ultrasound (POCUS) is increasingly used in clinical practice. However, it's additional value next to conventional markers of disease activity has not been studied in paediatric Crohn's disease (CD). This study aimed to assess the clinical added value of POCUS in children with CD.

METHODS

Consecutive children with CD visiting the outpatient clinic were prospectively enrolled and underwent POCUS in addition to faecal calprotectin (FC) test and mucosal inflammation noninvasive index for paediatric Crohn's disease (MINI-index) assessment. Both tests were categorised into normal, uncertain and abnormal. Paediatric gastroenterologists decided on clinical management before and after POCUS disclosure. Predictive value of POCUS for clinical flares within 4 months was assessed. Outcomes were the proportion (95% CI) of patients where POCUS result was discordant from FC and MINI-index, proportion of patients where POCUS changed clinical management, and predictive values of POCUS for clinical disease flares.

RESULTS

We included 76 patients (median age: 16 years, 34 (45%) female, median disease duration: 2 years). In 7 (9% (4%-18%)), and 2 (3% (0%-9%)) patients, the POCUS resulted in a less severe classification and in 43 (57% (45%-70%)), and 44 (58% (46%-69%)), in a more severe classification of disease severity compared to FC and MINI-index, respectively. Clinical management was adjusted in 46 (58%) cases after POCUS result disclosure. The positive and negative predictive value for clinical flares within 4 months of an abnormal POCUS were 71 (57%-82)% and 74 (64%-83)%, respectively.

CONCLUSIONS

POCUS seems a valuable noninvasive monitoring tool for children with CD. Our results support the application of POCUS in the clinical management of these children.