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特发性炎症性肠病患者的风湿性表现:一项单三级中心的跨学科研究

Rheumatic Manifestations in Patients with Idiopathic Inflammatory Bowel Disease: A Single Tertiary Centre, Interdisciplinary Study.

作者信息

Kavvadias Athanasios, Karavasili Maria, Pelechas Eleftherios, Christodoulou Maria Veatriki, Paraskevi V Voulgari, Katsanos Konstantinos H, Christodoulou Dimitrios K

机构信息

Department of Gastroenterology.

Department of Ophthalmology.

出版信息

Mediterr J Rheumatol. 2025 May 23;36(2):215-219. doi: 10.31138/mjr.291123.ept. eCollection 2025 Jun.


DOI:10.31138/mjr.291123.ept
PMID:40757119
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12312475/
Abstract

BACKGROUND: Inflammatory bowel disease is closely associated with extraintestinal manifestations. Among them, joint involvement and enthesitis are the most frequent resembling a spondyloarthropathy. Enthesitis may be clinically silent in a high proportion of these patients without any clinical signs or a diagnosis of spondyloarthritis. OBJECTIVES: To evaluate, with the use of musculo-skeletal ultrasound, the frequency and location of musculoskeletal manifestations in patients with inflammatory bowel disease. METHODS: Fifty patients with a definite diagnosis of inflammatory bowel disease were prospectively recruited and clinically evaluated by a rheumatologist for relevant musculoskeletal symptoms. All of the patients underwent a thorough musculo-skeletal ultrasound examination of both knees, patellae, as well as upper and lower limbs, in order to identify synovitis, and enthesitis. Musculo-skeletal ultrasound examination was performed at 12 entheses. The ultrasound abnormalities were scored according to the Madrid Ankylosing Spondylitis Enthesitis Index. Results: The musculo-skeletal ultrasound examination performed, revealed the presence of synovitis in 24% and enthesitis in 64% of these patients. More specifically, in 6.3% of the "Quadriceps tendon", in 40.6% in the "Achilles tendon", in 40.6% in the "Quadriceps and Achilles", in 9.4% in the "Triceps, Quadriceps and Achilles' and at a rate of 3.1% in the 'Patella'. CONCLUSIONS: The musculo-skeletal ultrasound verified that a significant percentage of the patients exhibit some type of "musculoskeletal manifestations", with enthesitis to be the most common of them in patients suffering from inflammatory bowel disease.

摘要

背景:炎症性肠病与肠外表现密切相关。其中,关节受累和附着点炎最为常见,类似于脊柱关节炎。在这些患者中,很大一部分附着点炎可能没有任何临床体征或脊柱关节炎的诊断,临床上未被察觉。 目的:使用肌肉骨骼超声评估炎症性肠病患者肌肉骨骼表现的频率和部位。 方法:前瞻性招募50例确诊为炎症性肠病的患者,并由风湿病学家对相关肌肉骨骼症状进行临床评估。所有患者均接受了对双膝、髌骨以及上肢和下肢的全面肌肉骨骼超声检查,以确定滑膜炎和附着点炎。在12个附着点进行了肌肉骨骼超声检查。根据马德里强直性脊柱炎附着点炎指数对超声异常进行评分。结果:所进行的肌肉骨骼超声检查显示,这些患者中24%存在滑膜炎,64%存在附着点炎。更具体地说,“股四头肌肌腱”处为6.3%,“跟腱”处为40.6%,“股四头肌和跟腱”处为40.6%,“肱三头肌、股四头肌和跟腱”处为9.4%,“髌骨”处为3.1%。 结论:肌肉骨骼超声证实,相当一部分患者表现出某种类型的“肌肉骨骼表现”,附着点炎是炎症性肠病患者中最常见的表现。

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本文引用的文献

[1]
Enthesitis in IBD Patients.

J Clin Med. 2024-8-3

[2]
Inflammatory Bowel Disease-related Spondyloarthritis: The Last Unexplored Territory of Rheumatology.

Mediterr J Rheumatol. 2022-4-15

[3]
Musculoskeletal Ultrasound to Identify Subclinical Joint and Periarticular Involvement in Patients With Inflammatory Bowel Disease: A Systematic Literature Review.

Front Med (Lausanne). 2022-5-16

[4]
High Prevalence of Ultrasound Verified Enthesitis in Patients With Inflammatory Bowel Disease With or Without Spondylarthritis.

Front Med (Lausanne). 2021-2-12

[5]
Contemporary imaging of rheumatoid arthritis: Clinical role of ultrasound and MRI.

Best Pract Res Clin Rheumatol. 2020-12

[6]
Ultrasonographic and clinical assessment of peripheral enthesitis and arthritis in an Italian cohort of inflammatory bowel disease patients.

Semin Arthritis Rheum. 2020-6

[7]
The Declaration of Helsinki on Medical Research involving Human Subjects: A Review of Seventh Revision.

J Nepal Health Res Counc. 2020-1-21

[8]
OMERACT Definitions for Ultrasonographic Pathologies and Elementary Lesions of Rheumatic Disorders 15 Years On.

J Rheumatol. 2019-2-1

[9]
Influence of Disease Manifestations on Health-related Quality of Life in Early Psoriatic Arthritis.

J Rheumatol. 2018-7-1

[10]
Rheumatic manifestations of inflammatory bowel diseases: A study from the Middle East.

J Int Med Res. 2018-9

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