PT  - JOURNAL ARTICLE
AU  - Devis Benfaremo
AU  - Michele Maria  Luchetti
AU  - Marco  Di Carlo
AU  - Bruno Laganà
AU  - Andrea Picchianti-Diamanti
AU  - Francesco Carubbi
AU  - Roberta Pica
AU  - Maria Sole  Chimenti
AU  - Roberto Lorenzetti
AU  - Palma Scolieri
AU  - Vincenzo Bruzzese
AU  - Antonio Benedetti
AU  - Roberta Ramonda
AU  - Roberto Giacomelli
AU  - Fausto Salaffi
AU  - Armando Gabrielli
TI  - Multicenter validation of the DETAIL questionnaire for the screening of spondyloarthritis in patients with inflammatory bowel diseases
AID  - 10.3899/jrheum.200364
DP  - 2020 Jul 15
TA  - The Journal of Rheumatology
PG  - jrheum.200364
4099  - http://www.jrheum.org/content/early/2020/07/09/jrheum.200364.short
4100  - http://www.jrheum.org/content/early/2020/07/09/jrheum.200364.full
AB  - Objective Spondyloarthritis (SpA) is among the most frequent extra-intestinal manifestations in inflammatory bowel diseases (IBD). In this study, we aimed to validate the DETection of Arthritis in Inflammatory bowel diseases (DETAIL) questionnaire in a multicenter cohort of IBD patients enrolled at eleven Gastroenterology Units. Methods From October 2018 to March 2019, consecutive adult patients with IBD, either Crohn’s disease or ulcerative colitis, filled out independently the DETAIL in the outpatient waiting room. Within two weeks a blinded rheumatologist assessed all the patients, irrespectively of the DETAIL results, and classified them to be affected or not by SpA. The performance of the items was evaluated trough Bayesian analysis. Results Overall, 418 IBD patients filled out the DETAIL questionnaire. Upon rheumatological evaluation, 102 (24.4%) patients received a diagnosis of SpA. Of the six questions, the best performances were found in item 6 (LR+ 3.77), reporting inflammatory back pain at night, and in item 3 (LR+ 3.31), exploring Achilles enthesitis. The presence of back pain lasting more than three months (LR+ 2.91), of back pain with inflammatory features (LR+ 2.55) and a history of dactylitis (LR+ 2.55), showed also a fairly good performance, whereas a history of peripheral synovitis was slightly worse (LR+ 2.16). The combination of at least three items answered affirmatively yields a post-test probability of SpA of 80% or more. The presence of alternative diagnoses, such as osteoarthritis or fibromyalgia, represented a minor confounder. Conclusion The DETAIL questionnaire is a useful tool for the early detection of SpA in IBD.