P213 High prevalence of subclinical ultrasonographic synovitis in patients with inflammatory bowel...

Clinical: Diagnosis & outcome S151

and standard histhology landmarks of IBD were not reportedexplicitely in half-to-two thirds of the examinations.

Table: Relevant characteristics of endoscopy/clinical andhistopathology records; raw percentages of 311 recordsanalysed are reported.

Characteristic Observed

Characteristics of information sent to pathologistsIndication of timing (first diagnosis/follow-up) 84%Symptoms description 24%Active treatments description 15%Indication of time from symptoms onset 12%Laboratory results (biochemistry) <5%Bioptic sampling characteristicsStandard sampling fulfilled (at least 2 biopsies from ileum + each segment) 10%Biopsies oriented on acetate strips 0%Characteristics of histopatology reportFinal diagnosis of IBD explicitly stated 47%Cryptitis/crypt abscess described 56%Crypt architectural distortion described 38%Ulcers described 31%Basal plasmocytosis described 3%

Conclusions: These preliminary results outline that standardsof quality prescribed by ECCO guidelines are rarely metin clinical practice. Nonetheless, a conclusive diagnosticclassification is achieved in slightly less than half of the recordsexamined. Basal plasmocytosis, which appear to be a relevantIBD landmark, was seldom reported in this series.These results suggest that there is place for educationalinterventions aimed at ameliorating clinicians-pathologistsinterplay and to increase the quality of endoscopic samplingand of histopathological reports.

P213High prevalence of subclinical ultrasonographic synovitisin patients with inflammatory bowel disease

E. Vicente1, S. Perez2 *, M. Chaparro3, F. Rodríguez-Salvanes4,S. Castaneda1, J.P. Gisbert3. 1Hospital La Princesa, IIS-P,Rheumatology Department, Madrid, Spain, 2FundacionJimenez Díaz, Rheumatology Department, Madrid, Spain,3Hospital Universitario de La Princesa, IP and CIBERehd,Gastroenterology Unit, Madrid, Spain, 4Hospital La Princesa,IIS-P, Epidemiologic Research Unit, Madrid, Spain

Background: A relevant proportion of inflammatory boweldisease (IBD) patients suffers musculoskeletal manifestations,such as peripheral arthritis, axial disease and entesitis. Powerdoppler ultrasonography (PDUS) has been shown to have highersensitivity than physical examination detecting synovitis, so itmay be useful to identify subclinical joint alterations and toestablish an early diagnosis of arthritis associated with IBD.Objective: To evaluate the prevalence of synovitis by PDUSexamination in IBD patients without musculoskeletal signsand symptoms and to identify predictive factors for thedevelopment of synovitis.Methods: IBD patients from our out-patients clinic withoutmusculoskeletal symptoms were prospectively included during2012. Blinded gastroenterological, rheumatological and PDUSevaluation were performed. Clinical characteristics andphysical activities were evaluated, and musculoskeletal clinicalexamination was performed. PDUS evaluation consisted ofthe detection of grey scale (GS) synovitis and synovial PDUSsignal in 44 joints (bilateral sternoclavicular, acromioclavicular,glenohumeral, elbow, carpal, MCP, PIP, knee, ankle and MTPjoints) using a LOGIQ7 General Electric machine with a12-MHz linear array transducer. US variables were scoredbinary (present/absent) and semiquantitatively. The intra-reader agreement for US was estimated in all images obtained.Results: Twenty-three IBD patients (56% male), 9 Crohn’sdisease and 14 ulcerative colitis, have been included so far.Clinical variables: age 42±12 years, evolution time 9 years(range: 0.1 33), CDAI 28±21, Mayo index 0.4±1, DiseaseModifying Anti-Rheumatic Drugs therapy in 91.3% for 5.5±5

years, ESR 12±8.8 mm/h and CRP 0.12±0.1 mg/dL. GS jointeffusion and synovial hypertrophy in at least 1 joint werepresent in 91.3% and 100%, respectively, with polyarticular(�5 joints) involvement in 48% and 74%, respectively, whichwas mostly mild or moderate. Mild or moderate PDUS signalwas positive in 48% of patients. Joint effusion and synovialhypertrophy were more frequent in MTF, MCF and carpaljoints, and PDUS in carpal and knee joints. We found noassociation between PDUS variables and clinical and analyticalIBD variables. The intra-reader agreement was high (0.8 intra-class correlation variability).Conclusions: Subclinical articular PDUS abnormalities arefrequently present in IBD patients, independently of activity,evolution time and clinical subtype. Their predictive role onthe development of clinical musculoskeletal disease should beinvestigated in prospective longitudinal studies.

P214Health-related quality of life among patients with primarysclerosing cholangitis

J. Haapamaki1 *, H. Sintonen2, N. Barner-Rasmussen1,M. Farkkila1. 1Helsinki University Central Hospital, Division ofGastroenterology, Helsinki, Finland, 2University of Helsinki,Department of Public Health, Hjelt Institute, Helsinki,Finland

Background: The aims of the study were to assess health-related quality of life (HRQoL) of patients with primarysclerosing cholangitis (PSC) and to compare it with that ofthe general population, and to examine changes in HRQoL innewly diagnosed PSC patients in 1 to 2 years’ follow-up, aswell as to compare their HRQoL with that of newly diagnosedinflammatory bowel disease (IBD) patients.Methods: The patients, picked from the Helsinki UniversityCentral Hospital’s (HUCH) PSC register, filled in the surveyquestionnaire when attending their first or subsequentendoscopic retrograde cholangiography (ERC) examination atHUCH. The follow-up questionnaire was sent to those newlydiagnosed by mail 1 to 2 years after diagnosis. Data froma national health survey was used for comparison of HRQoLbetween PSC patients and the general population and dataabout HRQoL of newly diagnosed IBD patients came from anearlier HRQoL survey [1]. The general 15D tool served as ameasurement of HRQoL and severity of PSC was graded byscoring the ERC findings according to a modified version ofPonsioen [2] separately for intra- and extrahepatic changes.A sum score was calculated.

Figure: 15D profiles of PSC patients and controls. *Significant differences.

Results: The mean age of the patients was 43.3 years (18 78years), and the duration of PSC 0 29 (mean 5.5) years.Most of the patients had no symptoms of PSC. Of all thepatients, 69.5% also had inflammatory bowel disease. Older