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Study: Ultrasound able to identify heel enthesitis in 25% of patients with IBD

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About a quarter of patients with inflammatory bowel disease had evidence of heel enthesitis and spondyloarthritis on ultrasound, but the findings did not correlate with serum levels of vitamin D, according to recently presented research.

Of 100 patients with inflammatory bowel disease (IBD) recruited, 52 had ulcerative colitis (UC), 48 had Crohn’s disease (CD) and 30 patients were recruited into a control group. Ultrasound evaluation was performed by an experienced rheumatologist who was not blinded to the clinical characteristics of the patients. The Achilles tendon was assessed using the OMERACT enthesopathy scoring systems. Patients were considered deficient in vitamin D at levels lower than 20 ng/mL, insufficient for levels between 20 ng/mL and 30 ng/mL, and sufficient at levels between 32 ng/mL and 100 ng/mL. Levels higher than 100 ng/mL were considered excessive.

Ultrasound was performed in 200 heel regions of the 100 patients. A power Doppler (PD) change was seen in 38 patients with UC, and a gray scale (GS) change was seen in 20 patients. Changes on ultrasound were seen in 16 patients with UC and in nine patients with CD. Twelve patients with CD had PD changes, and 12 patients had detectable GS change. The mean total ultrasonographic score was 1.98 in the 52 patients with UC and 0.83 in the 48 patients with CD, compared with a score of zero in the control group.

Mean vitamin D level in patients with UC was 14.72 ng/mL and 11.86 ng/mL in patients with CD compared with 16.06 ng/mL in the control group, a difference that was considered insignificant, according to the researchers. No correlation was found between levels of vitamin D and total ultrasound scores. – by Shirley Pulawski

Reference:

Kimyon G, et al. Paper #AB0765. Presented at: European League Against Rheumatism Annual European Congress of Rheumatology; June 10-13, 2015; Rome.

Disclosure: The researchers report no relevant financial disclosures.