Does ultrasound detect joint and intestinal changes in psoriatic arthritis and ulcerative colitis after immunobiological treatment: A case report.

Abstract

Background: Ultrasound (US) can be a valuable tool for assessing arthritis associated with inflammatory bowel disease (IBD), especially in cases of psoriatic disease. The clinical case reviewed in this article addresses an exploratory finding that evaluates the effects of immunobiological treatments on dactylitis and IBD with the use of US techniques.

Case summary: A 40-year-old Caucasian woman with psoriatic arthritis (PsA) and ulcerative colitis (UC) reported experiencing finger pain, knee arthritis, and bloody diarrhea. She showed a high Disease Activity index for PsA score and a severe Mayo score. She began treatment with adalimumab. Over the course of six months, the 18 MHz US procedure was performed on her joints and a 3.5 MHz US on her intestines. The joint US indicated dactylitis and swelling in her finger joints, while the intestinal US revealed 6.6 mm swelling in the sigmoid colon, increased abdominal fat, and high Doppler signal. Her fecal calprotectin level was 5984 mg/kg, and a colonoscopy showed that UC extended to the hepatic flexure, along with mild narrowing of the transverse colon. After six months treatment, all parameters showed improvement, including a remission of the Mayo score, better colonoscopy results, and Limberg score of 0.

Conclusion: More research is needed to find out the importance of using US in patients with PsA and UC as this could improve treatment strategies.