Fibromyalgia, SpA in IBD Is Differentiated By Ultrasonography

Ultrasonography examination may aid in discerning between fibromyalgia and spondyloarthopathy (SpA) among patients with inflammatory bowel disease (IBD), according to a new study.

“Joint pain is common in subjects with IBD and is linked to several factors including SpA, drug therapy, concomitant [osteoarthritis], or [fibromyalgia],” the researchers wrote. “The primary aim of this study was to estimate the prevalence of primary fibromyalgia and concomitant fibromyalgia and SpA in a cohort of patients with IBD utilizing clinical and [ultrasonography] assessment.”

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The 301 participants included in the study were from 2 IBD units and had been assessed by the Assessment of SpondyloArthritis International Society criteria fulfilment for SpA or by the 2010 American College of Rheumatology (ACR) criteria for fibromyalgia.

Of the 12% meeting ACR criteria for fibromyalgia, 9% presented with primary fibromyalgia and 3.3% presented with concomitant fibromyalgia and SpA.

The participants with fibromyalgia had higher scores on the Leeds Enthesitis Index, Bath Ankylosing Spondylitis Disease Activity Index, and Bath Ankylosing Spondylitis Functional Index than the participants with SpA, the researchers reported. 

Among 158 participants who underwent ultrasonography entheseal examination on large insertions in the upper and lower limbs, those who met the Assessment of SpondyloArthritis International Society criteria for SpA had significantly higher mean enthesis or patient power Doppler positive compared with those with fibromyalgia. 

“Ultrasound examination in a large patient subgroup showed a promising discriminating capacity between fibromyalgia and spondyloarthopathy in IBD patients,” the researchers concluded.

—Jolynn Tumolo

Reference:

Martinis F, Tinazzi I, Bertolini E, et al. Clinical and sonographic discrimination between fibromyalgia and spondyloarthopathy in inflammatory bowel disease with musculoskeletal pain. Rheumatology (Oxford). 2020;59(10):2857-2863. doi:10.1093/rheumatology/keaa036