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Study: Sacroiliac joint abnormalities preceded SpA in some patients with IBD
Asymptomatic sacroiliac joint abnormalities may be a predictor of the future development of spondylarthropathy in a small percentage of patients with inflammatory bowel disease, according to study findings.
Researchers analyzed 81 patients with remittent and low active inflammatory bowel disease (IBD; 55 with Crohn’s disease and 26 with ulcerative colitis) from a tertiary referral center in Italy using postero-anterior and dedicated oblique sacroiliac joint (SIJ) X-rays. The researchers reviewed differences in IBD clinical and laboratory data for the patients with and without SIJ X-ray findings, and those with SIJ abnormalities were followed-up for 3 years to determine the onset of chronic inflammatory back pain — defined as pain for more than 3 consecutive months. T2 fat suppression and T1 contrast sequences at MRI were used to define bone edema or osteitis in the earlier phases of disease.
Asymptomatic radiological SIJ abnormalities were seen in 27.1% of the patients at baseline, with 17 patients exhibiting isolated sclerosis and 12 patients exhibiting localized erosions and sclerosis, according to the researchers. The researchers also found radiological SIJ involvement had no correlation to clinical or familial IBD variables.
At 3-year follow-up, four of the 22 patients had developed chronic inflammatory back pain, with symptoms of bone edema observed on MRI. The researchers concluded that the fact that none of the patients were human leukocyte antigen-B27 positive may highlight the importance of imaging for SpA subclinical involvement among patients with IBD.
Disclosure: The authors have no relevant financial disclosures.