The prevalence of asymptomatic early sacroiliitis in Crohn’s disease patients: The single experience of an Italian tertiary care centre

Background The inflammatory involvement of sacroiliac joint is one of the most frequent and underestimated extra-intestinal manifestation in patients with inflammatory bowel disease. The early recognition of a sacroiliitis can prevent their progression to definite spondyloarthritis with worsening of quality of patients’ life. The use of magnetic resonance imaging might be useful to detect early and asymptomatic sacroiliitis. The aim of this study is to assess the prevalence of early sacroiliitis in asymptomatic patients affected by Crohn’s disease who undergo to abdominal magnetic resonance imaging for the staging of bowel disease. Methods The retrospective study included 121 patients affected by Crohn’s disease who refer to the Department of Gastroenterology and undergo consecutively to the abdominal magnetic resonance imaging for the staging of the bowel disease, enrolled from January 2012 to January 2017. The assessment of sacroiliitis and Crohn’s disease by magnetic resonance imaging was made using T1-weighted spin-echo [TISE], short tau inversion recovery [STIR] and fat-saturated T2-weighted sequences. Results At the abdominal magnetic resonance imaging, 35 (28.9 %) of patients have an asymptomatic bone marrow oedema of the sacroiliac joint. At the logistic regression, the previous surgical therapy is a statistical significant predictive factor of sacroiliitis (OR 3.27, 95% CI 1.45–7.41, p = 0.004) and the previous biological therapy with anti-TNF seems to be a protective factor (OR 0.79, 95% CI 0.26 - 2.36, p = 0.67).Conclusions Our study underlines the presence of an asymptomatic and early sacroilitiis in patients affected by Crohn's disease and the need for tight control of Crohn's patients using also cross-sectional methods for a complete control of disease and an integrated multidisciplinary approach in order to identify a therapeutic strategy, especially in the era of the new biologic therapies.