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

## TL;DR

This study used ultrasound to find that many inflammatory bowel disease patients have musculoskeletal issues, especially enthesitis.

## Contribution

The study reveals the high prevalence of enthesitis in IBD patients using musculoskeletal ultrasound.

## Key findings

- Musculoskeletal ultrasound detected synovitis in 24% and enthesitis in 64% of IBD patients.
- Achilles tendon was the most common site of enthesitis, affecting 40.6% of patients.
- Enthesitis was more prevalent than clinically suspected in IBD patients.

## Abstract

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.

To evaluate, with the use of musculo-skeletal ultrasound, the frequency and location of musculoskeletal manifestations in patients with inflammatory bowel disease.

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’.

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.