Discovertebral erosions in patients with enteropathic spondyloarthritis.

OBJECTIVE

Magnetic resonance imaging (MRI) is considered the modality of choice for the diagnosis of spondyloarthropathy (SpA)-related spondylodiscitis, or discovertebral erosions (DE). Our aim was to analyze the prevalence and the clinical features of DE in patients with enteropathic SpA (EA) using MRI.

METHODS

We evaluated 72 patients with EA and 43 controls for the study. All patients and controls underwent rheumatological and gastroenterological clinical examinations, and demographic features were recorded. For each patient, these factors were also recorded: duration of inflammatory bowel disease and arthritis from onset to enrollment, history of viral and bacterial infections, and occurrence of previous major trauma to the spine. These scores were taken: Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Harvey-Bradshaw Index, and the Simple Clinical Colitis Activity Index. All subjects had MRI of the spine.

RESULTS

On the basis of inclusion criteria, 43 patients with EA were included in the study. Twenty-three had axial EA (axEA) and 20 had axial and peripheral subset EA (overlap subset or peripheral type 3; axphEA). Twenty-two patients with EA (15/7 axEA/axphEA) showed DE (30.55%; p < 0.001). DE was significantly more prevalent in axEA subjects than in the overlap subset (p < 0.001). In axEA, DE had a significant direct correlation with arthritis duration (r = 0.546, p = 0.007). Patients with DE showed BASDAI, BASMI, and BASFI scores significantly higher than patients without DE (p < 0.001).

CONCLUSION

We found a high prevalence of DE among patients with EA (30.55%), confirming that DE is an important characteristic aspect of SpA. We found a high prevalence in patients in the axphEA subset (31.82%), suggesting that DE could be a characterizing feature of the overlap subset.