Sonographic Prevalence of peripheral Enthesitis Among patients with Inflammatory Bowel Disease (IBD)

Background: Musculoskeletal manifestations are the most frequent extra-intestinal complications of IBDs, and they are an important cause of morbidity and impairment of quality of life. Aim: to assess the prevalence (frequency and pattern) of peripheral enthesitis in patients with IBD by using B-mode ultrasonography and power Doppler ultrasonography (PDUS) with Glasgow Ultrasound Enthesitis Scoring System (GUESS) and correlate these findings with clinical and laboratory parameters of IBD. Patients and Methods: In this observational study 50 people with inflammatory bowel diseases (IBD)—ulcerative colitis (UC), Crohn's disease (CD), and rheumatoid arthritis (RA)—were included, there were 33 The patients chosen from those who visited Al-Azhar University Hospital's outpatient gastroenterology, hepatology and tropical medicine, and rheumatology and rehabilitation departments from December 2021 to August 2022. Results: Significant relationship between inflammatory back pain and X-Ray of Sacroiliac joint as severity of sacroiliacs was significantly increased with patients with inflammatory back pain, significant positive correlation between GUESS score and Mayo partial score and there a significant positive correlation between disease duration and Mayo partial score. No significant difference between sonographic findings at entheseal sites and Disease duration of IBD, Musculoskeletal Ultra-sonographic examination at entheseal sites and comorbidity, Bilateral entheseal examination. Significant positive correlation between GUESS score (total) with total cholesterol and triglycerides in UC group only and GUESS score (total) and ESR in both groups. GUESS score (total) and History of extra-intstinal manifestation of the studied patients there was a significant regarding History of inflammatory back pain. Conclusion: Musculoskeletal Ultrasonography is a suitable and reliable method for examining entheseal structures with great resolution because most of these are superficial structures. Entheseal abnormalities can be documented by ultrasonography in clinically asymptomatic patients with IBD. These findings could be related to a subclinical entheseal inflammation.