INTRODUCTION In patients with inflammatory bowel disease (IBD), co-occurring spondyloarthritis (SpA) leads to poorer outcomes and impaired quality of life, highlighting the importance of early detection and effective treatment. This is the first study to assess the prevalence and distribution of axial symptoms and magnetic resonance imaging (MRI)-detected involvement of the spine and sacroiliac joints (SIJs) in early IBD. METHODS Newly diagnosed patients with IBD from a prospective, population-based cohort were consecutively recruited. Rheumatological interview, clinical, ultrasound, and MRI assessment for SIJ and spine inflammatory and structural lesions were made using validated scoring methods and consensus definitions of axial SpA (axSpA). RESULTS Of 110 patients (ulcerative colitis: 70, Crohn's disease: 40, mean age of 42 years, and 40% male), 48 (44.9%) reported back and/or buttock pain, and 10 (9.1%) had inflammatory back pain. Seventeen (16.7%) patients had MRI findings indicative of axSpA; only 10 of these patients had axial symptoms. Inflammatory MRI lesions were present in SIJs and the spine of 27 (26.5%) and 30 (30.3%) patients, respectively. The Assessment of SpondyloArthritis International Society classification criteria for axSpA were met in 11 (10%) cases. MRI findings typical of axSpA were associated with peripheral joint and entheseal inflammation detected by ultrasound ( P = 0.04). No differences in clinical or imaging findings were found between patients with ulcerative colitis and Crohn's disease. DISCUSSION One-in-6 newly diagnosed patients with IBD had MRI findings indicative of axSpA. As 40% of these patients were asymptomatic, this suggests that axSpA is underdiagnosed in early IBD. Multidisciplinary collaboration is essential to ensure early detection of axial inflammation and to enable optimal therapy preventing future structural damage and disability.

中文翻译：

---

新诊断的炎症性肠病患者的脊柱和骶髂关节受累：来自基于人群的队列的临床和 MRI 结果。


引言 在炎症性肠病 （IBD） 患者中，同时发生的脊柱关节炎 （SpA） 会导致预后变差和生活质量受损，这凸显了早期发现和有效治疗的重要性。这是第一项评估早期 IBD 中轴症状和磁共振成像 （MRI） 检测到的脊柱和骶髂关节 （SIJ） 受累的患病率和分布的研究。方法 连续招募来自前瞻性、基于人群的队列的新诊断 IBD 患者。使用经过验证的评分方法和轴向 SpA （axSpA） 的共识定义，对 SIJ 和脊柱炎症和结构病变进行风湿病访谈、临床、超声和 MRI 评估。结果 在 110 例患者 （溃疡性结肠炎： 70， 克罗恩病： 40， 平均年龄 42 岁， 40% 为男性） 中，48 例 （44.9%） 报告背部和/或臀部疼痛，10 例 （9.1%） 有炎症性背痛。17 例 （16.7%） 患者的 MRI 结果提示 axSpA;这些患者中只有 10 例有轴性症状。炎症性 MRI 病灶分别存在于 27 例 （26.5%） 和 30 例 （30.3%） 患者的 SIJ 和脊柱中。11 例 （10%） 病例符合 axSpA 国际脊柱关节炎协会评估分类标准。axSpA 的典型 MRI 结果与超声检测到的外周关节和附着点炎症相关 （ P = 0.04）。溃疡性结肠炎患者和克罗恩病患者之间的临床或影像学表现无差异。讨论 每 6 名新诊断的 IBD 患者中就有 1 名的 MRI 结果提示 axSpA。由于这些患者中有 40% 无症状，这表明 axSpA 在早期 IBD 中被低估。 多学科合作对于确保早期发现中轴炎症和实现最佳治疗以防止未来的结构损伤和残疾至关重要。