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Background Assessment of disease activity in systemic sclerosis (SSc) is challenging and usually hard to distinguish from damage or chronicity. Objectives We aimed to evaluate disease activity by different indexes and compare them in a SSc cohort. Methods Disease activity was evaluated by revised EUSTAR (European Scleroderma Trials and Research group) and EScSG (European Scleroderma Study Group) activity indexes in 131 SSc patients fullfiling ACR/EULAR classification criteria (2013). The patients with the scores of EUSTAR activity index ≥2.5 or EScSG activity index ≥3 were accepted as having active disease. Results Demographics, disease characteristics and nailfold video-capillaroscopic (NVC) pattern details were summarised in table-1. The scores of EUSTAR and EScSG activity indexes were correlated well (r=0.576, p=0.000) and the agreement between two scores for activity was moderate (cohen kappa:0.407). The percentages of SSc patients described as having active disease or not according to two activity indexes were summarised in table-2. Of the patients, 9.9% had active and 70.9% had inactive disease according to both indexes in this SSc cohort. Twenty -one (for EUSTAR) and 4 patients (for EScSG) were described as active according to one index and not to the other. Revised EUSTAR activity index was found to have 76.5% sensitivity and 81.6% specificity when the activity was defined by EScSG activity index. Conclusion This SSc cohort predominantly had limited cutanous disease, digital vasculopathy and late scleroderma pattern. Defining active disease was differed in 19% of the patients according to EUSTAR and EScSG activity indexes, former described higher frequency for activity. This difference might be related to validation procedures of these indexes in patients with different predominant stages of SSc disease, content of the index and the features of the cohort. Disclosure of Interests None declared

Background Salivary flow rates (SFR) and oral health were known to be frequently impaired in Sjogren’s syndrome (SjS) due to chronic inflammation and destruction of the salivary glands. Ultrasonography (USG) of major salivary glands (SG-USG) is a non-invasive widely used tool to evaluate salivary glands in SjS. Objectives The aim of the study was to assess the relationships between SFRs, oral health and USG changes of major salivary glands in patients with primary SjS. Methods Fifty-nine SjS patients (F/M:57/2) with the mean age of 52.2±11.5 years. The duration of follow-up period of 9.±7.1 years fulfilling ACR-EULAR classification criteria (2002) were included. Major salivary glands (bilateral parotis and submandibular glands) were scored according to two different scoring systems which are Hocevar A.(0–48) and Milic VD. (0–12). Oral health was assessed by indices. Measurements of whole unstimulated and stimulated SFRs were carried out in patients between 9 a.m. and 10 a.m in the morning. Oral health related quality of life (OHRQoL) as a patient reported outcome measure was evaluated by using Oral health impact profile (OHIP-14). High scores indicated poor OHRQoL status. Pathologic findings in oral health (GM) and USG images (NI) were evaluated by two authors as double-blind. Results Unstimulated SFR (0,2±0,2 ml/min) was correlated with stimulated SFR (1,1±0,7 ml/min) in the whole group (r=0,8 p=0.000). Moderate correlations were seen between unstimulated and stimulated whole SFRs and scores of hypoechogenic areas in bilateral parotid and submandibular glands (p Conclusions Unstimulated and stimulated SFRs were found correlated with the structural changes of major salivary glands. Tooth loss and poor OHRQoL were shown in patients due to reduced salivary outputs. USG images of salivary glands could give insight to physicians about oral health and OHRQoL as outcome measure in patients with SjS. Disclosure of Interest None declared

Objectives In this study, we aimed to investigate the concordance of ultrasonographic remission with other remission criteria and to show the influence of non-inflammatory patient-induced factors such as depression, anxiety, fibromyalgia and fatigue on both clinical and ultrasonographic remission. Methods Fifty consecutive patients with clinical remission (DAS-28-ESR Patients were also assessed whether they met the Boolean and SDAI remission criteria. 28 joint grey scale (GS) and power Doppler (PD) ultrasonography were performed. Patients‘ depression and anxiety were assessed by The Hospital Anxiety and Depression Scale (HADS), and their fatigue was assessed by multidimensional Assessment of Fatigue (MAF) scores and patients’ fibromyalgia was assessed by widespread pain index (WPI) and symptom severity score (SS). Results Patients were divided into 4 groups according to different remission definitions by ultrasonography. (Group1: PD=0 and GS=0, Group2: PD=0 and GS ≥0, Group3: PD=1 or 0 and GS=1 or 0, Group4: PD=1 or 0 and GS ≥0). Although it is not statistically significant, the highest agreement with all the clinical remission criteria was found in the USG remission group 4 (table 1). Patients with ultrasonographic remissions at their first visit in 2011 were reevaluated with clinical remission criteria at the end of 5 years. The highest remission rates were found in patients with USG remission group 3 (DAS28 58%, Boolean 29%, SDAI 47%). There was no significant difference between fatigue, fibromyalgia, depression and anxiety measures between remission and non-remission in all USG remission groups. In contrast, depression (p Conclusions Clinical and ultrasonographic remission was found to be compatible in half of the patients. The compliance of the USG remission in Group 4 with the clinical remission definitions was good, and clinical remission continuity was higher in the group meeting the definition of group 3. In contrast the ultrasound remission, the high levels of depression and anxiety in patients without SDAI and Boolean remission suggest that non-inflammatory patient-derived measures have less influence on the ultrasound remission. Disclosure of Interest None declared

Background The number and morphology of telangiectases (T) have been studied in terms of severity and organ involvement in sytemic sclerosis (SSc). T are located more frequently on face and trunk than extremities. Objectives We aimed to evaluate the impact of the localisation of T on different skin areas in addition to number on disease severity of SSc. Methods SSc patients fulfilling ACR/EULAR classification criteria (2013) who had the manifestation T were included. The number of T were calculated by using telangiectasia score (TS) (Shah A., et al) and localisation was classified according to presence of T on extremities or not. Simultaneously; ealy, active and late scleroderma patterns (Cutolo et al.) were determined qualitatively and capillary number (CN) was calculated per linear mm at distal row quantitatively by using nail fold video-capillaroscopy (NVC) in all patients. Results In 113 (106 female) SSc patients with T; the mean age was 52±12, the duration of follow-up 57±62 months, Raynaud and non-Raynaud symptom 10±8 and 7±7 years. Limited cutaneous form was found to be in 77 (%68), ANA positivity in 102 (%90) ve anti-Scl70 positivity in 33 (%29) patients. In SSc patients with TS score ≥6 or extremity T; the duration of non-Raynaud symptom was found to be longer (p=0010 or 0,009), MRSS and activity scores were higher (p=0004 or 0012 and p=0010 or 0,009) and severity scores of general, peripheral vascular involvement and skin were higher (p=0022 or 0,014, p=0030 or 0025 and p=0006 or 0,02), digital ulcers and flexion contractures were more frequent (p=0008 or 0035 and p=0027 or 0,032), late NVC pattern was more frequent and CN was lower (p=0001 or 0003 and p=0001 or 0,007). When patients were classified in 3 groups according to TS and presence of extremity T, differences in terms of organ involvement, disease activity and severity scores and NVC findings were summarised in table 1. Conclusions Disease duration was shown to be long, disease activity and severity were high and NVC findings were severe in patients with high scores of TS and extremity T. In patients with lower TS the presence of T on extremities was found to be related to severe disease. The number and localisation of T was emphasised as they are easy to evaluate in clinical practice and may be useful in determining severe patients with SSc. Disclosure of Interest None declared

Background Ultrasonography (USG) of major salivary glands (SG-USG)is a non-invasive tool that has been used to evaluate salivary glands in primary and secondary Sjogren’s syndrome (SjS). Objectives We aimed to investigate relation between the ultrasonographic scoring of major salivary glands and systemic disease activity or salivary secretion in patients with primary SjS. Methods Seventy-five SjS patients (F/M:73/2) with the mean age of 52±12 and duration of follow-up period of 58±54 months fulfilling ACR-EULAR classification criteria (2002) were included. Disease activity indexes (Sjogren’s Syndrome Patients Reported Index (ESSPRI), Visual Analogue Scale (VAS), EULAR Sjogren’s Syndrome Disease Activity Index (ESSDAI)] were recorded. Simultaneously, sialometric evaluation of the salivary glands was performed. Major salivary glands (bilateral parotis and submandibular glands) were scored according to two different scoring systems [Hocevar A.(0–48) and Milic VD. (0–12)] and elastography was recorded as well. Results Demographics, clinical characteristics, disease activity indexes and SG-USG scores were summarised in table 1 and table 2. Forty-one (55%) and 45 (60%) patients had the cut-off values of ≥17 (Hocevar) and ≥6 (Milic USG). The patients with the scores of ≥17 (Hocevar) were found to have higher scores of ESSPRI-total (16±6 vs 13±7, p=0,045) and lower sialometry (4,6±4,7 vs 8,4±4,6 ml, p=0,002). Scores of Hocevar and Milic-USG were negatively correlated with sialometry (r=-,430, p=0001 and r=-,430, p=0,001). Hocevar, Milic and elastography-USG scores were shown to be higher in patients with sialometry of ≤1,5 ml (n=7)(28±3 vs 17±10, p=0,010, 8±1 vs 5±3, p=0006 and 9±1 vs 5±2, p=0,028) and anti-Ro positivity(n=24) (24±10 vs 13±8 7±3 vs 4±2, p Conclusions Hocevar scoring system of major salivary glands was found to be related to patient reported activity in SjS. USG scores were associated with reduced saliva secretion and anti-Ro positivity. Severe parotid involvement was shown to be related to anti-RO and La positivity. Evaluation of SG-USG including different scoring systems and elastography might reflect function of the salivary glands. Disclosure of Interest None declared

Background Lung involment is one of the extra-articular manifestations that is shown to be related to morbidity and mortality in Rheumatoid arthritis (RA). Objectives We evaluated the progression of lung involvement in RA patients receiving biological treatment. Methods Eighty RA patients fulfilling ACR/EULAR classification criteria (2010) receiving biologics who had high-resolution computerised tomography (HRCT) of chest within 6 months of respiratory symptoms (cough/dyspnea) and/or any pathology in chest radiography were included. Warrick score, evaluating alveolitis and fibrosis, was calculated in RA patients by using HRCT of chest. Results The demographics and clinical findings were summarised in table 1. In 29 RA patients with interstitial findings in HRCT of chest; 7 (24%) were regressed and 1 (4%) was progressed with biologic drugs. Findings of alveolitis and fibrosis were completely regressed in 2, only alveolitis component was completely regressed in 3 and partially in 2 patients. The patient who progressed had new findings of alveolitis (table 2). Twenty-one patients in whom Warrick scores did not change, 5 received rituximab (RTX) and 10 received TNF inhibitors (TNF-inh). The mean Warrick scores was improved after biologics (11,3±9 (3–30) vs 10,3±9 (0–30), p=0,035). The improvement in alveolitis scores was significant (2,1±1,6 vs 1,5±1,6, p=0,031) while fibrosis scores were not (9,2±7,7 vs 8,8±8). Initial and control Warrick scores were higher in RTX receivers (16±9 vs 9,2±8, p=0034 and 14,8±10,1 vs 8,4±8,1), but the improvement after biologics was not different. Conclusions This study revealed an improvement in alveolitis after biologic drugs in RA patients. Fibrosis was not found to be effected by therapy. Lung lesions were improved in both RTX and TNF-inh groups. Disclosure of Interest None declared

Background In patients with seronegative rheumatoid arthritis (RA) there is a difficulty to make the differential diagnosis with the spondyloarthropathies. Objectives To assess the presence of enthesitis in patients with seronegative RA in comparison with the healthy controls (HC), patients with seropositive RA and ankylosing spondylitis(AS). Methods In this cross-sectional study, seronegative and seropositive RA patients, who fulfilled the 2010 ACR/EULAR criteria, patients with AS and HC have been assessed by grey scale and power doppler ultrasonography for the presence of enthesopathy at the achilles tendon, plantar fascia, proximal patella, distal patella, quadriceps, tibialis anterior, triceps, common flexor and extensor tendons. Clinical assessment of the patient groups included demographic findings, health assessment questionnaire and DAS28. Results In our study, we recruited age and sex matched 27 seronegative RA, 19 healthy controls, 24 seropositive RA and 23 ankylosing spondylitis patients. We evaluated and analysed both right and left sides of the enthesis regions separately which have been indicated in the methods section. The mean DAS28, mean ESR and mean CRP of the patients with seronegative RA were 3.6±1.28, 32.2±21.2 and 12.37±27.77 respectively (table 1). Median of Madrid sonographic enthesitis index (MASEI) was 5 in patients with seronegative RA. 4 patients have severe scores (MASEI score ≥20). There were significant differences between seronegative RA and healthy controls (MASEI score:3), (p=0.014) but no differences has been observed between seronegative RA with seropositive RA (MASEI score:6) and anklosing spondylitis (MASEI score:7) in MASEI scores. In comparison, hypoechogenicity of quadriceps tendon (16 (29.6%) vs 6 (12.5%), p=0.037), bone erosion at the quadriceps tendon attachment (9 (16.6%) vs 0, p=0.003), calsification at achilles tendon (17 (31.4%) vs 6 (12.5%), p=0.023) have been observed more frequently in patients with seronegative RA than seropositive RA. Significantly higher number of patients with bone erosion at the common extansor tendon (26 (48.1%) vs 3 (6.5%), p= Conclusions We observed that enthesis involvement was not seldom in patients with seronegative RA. Furthermore there were also similar frequency of entesis involvement in seropositive patients with RA. The value of enthesis sites evaluation for the differential diagnosis of patients with seronegative RA should be further investigated and the assessment of enthesis sites in seronegative and seropositive RA patients can be important to detect active and chronic changes at the enthesis region. Disclosure of Interest None declared

Background TURKBIO registry is the Turkish version of Danish DANBIO rheumatologic database which has been established in 2011. Demographics and previous or current treatment with conventional (csDMARD) and targeted synthetic (tsDMARD), and biological DMARDs (bDMARDs) were collected. Objectives We aimed to investigate the efficacy and safety status of methotrexate (MTX) vs. leflunomide (LEF) use as a concomitant treatment with bDMARDs and tsDMARD in this registry. Methods Frequencies of achievement of remission or remission +low disease activity (LDA) at the 6th month of bDMARD or tsDMARD treatment were compared between patients who were on these medications with MTX vs. LEF as a concomitant treatment. Drug survival and switch rates of bDMARDs and tsDMARD treatments either with MTX or LEF were compared. The adverse effects with MTX and LEF concomitant use were evaluated as well. Results The study included 725 bDMARD or tsDMARD receiving RA patients from 8 participating centres of the TURKBIO registry. Of these patients, 462 (63.7%) were receiving concomitant MTX and 263 (36.3%) LEF. Demographic findings are given in the table 1. Achievement of remission and remission +LDA at the 6th month of bDMARD or tsDMARD initiation was similar in concomitant MTX vs LEF groups (51.4% vs. 53%, p=0.683). When each bDMARD and tsDMARD was evaluated separately, achievement of remission were again similar in MTX and LEF concomitant users (TNFi: 53% vs. 54%; ABA: 50% vs. 59%; RTX: 53% vs. 61%; TCZ: 42% vs. 35%; p>0.05 for all). For TOFA, although remission +LDA rate was numerically higher in MTX concomitant group than LEF group (42% vs. 21%), the difference was not statistically significant due to the smaller sample size of TOFA (n=33). The results were similar for all DMARD groups when remission was evaluated alone. Drug survival (17±12 vs. 16±11 months, p>0.05) and drug discontinuation (42,2 vs 38, p>0.05) rates of bDMARDs or tsDMARD were also not different in MTX vs. LEF concomitant users. Adverse effects rate (19.5% vs 20.5%, p>0.05) were similar between MTX vs. LEF concomitant users as well. Conclusions Achievement of remission or remission +LDA was not different with the concomitant use of MTX vs. LEF with any bDMARD or tsDMARD treatment in RA patients with a similar safety profile. LEF might be an alternative as a concomitant DMARD in MTX-intolerant RA patients initiating bDMARDs or tsDMARD. Disclosure of Interest None declared

Background Pulmonary involvement in rheumatoid arthritis (RA) is one of the extra-articular manifestations affecting morbidity and mortality during the course of the disease. Pulmonary function tests (PFTs) and thoracic high-resolution computerised tomography (HRCT) are the standard of care in the assessment of pulmonary involvement in RA. In this study, we aimed to compare the findings between self-reported questionnaires and HRCT to detect pulmonary abnormalities in RA patients. Methods Forty-two RA patients fulfilling ACR/EULAR classification criteria (2010) who had thoracic HRCT within 6 months of any symptom and/or any pathology on radiography of chest were included in the study. The patients were also assessed by modified Borg Scale, SF-36 Quality of Life Scale and Leicester Cough Questionnaire for the evaluation of respiratory symptoms. Results Demographics and clinical characteristics were summarised in table 1. Warrick score, assessing the severity and extent of alveloitis and fibrosis on thoracic HRCT, was evaluated in 15 patients with ILD (score range:4–28). DLCO values were lower in patients with Warrick score ≥1 (73±22% vs. 88±12%, p=0.019) while FVC were not found to be different. The findings of HRCT and self-reported questionnaires were summarised in table 2. Any relationship between self-reported questionnaires and Warrick scores was not detected. Presence of any parenchymal lesions was found to be associated with SF-36 total score (p=0,048). DLCO levels were found to be negatively correlated with SF-36 total scores (r=-0,470, p=0,006). Conclusions In this study, we could not show any relationship between self-reported questionnaires and thoracic HRCT findings, except a weak association of the presence of parenchymal lesions with SF-36 scores. Alveolitis and/or fibrosis on thoracic HRCT were found to be associated with lower DLCO. DLCO was shown to be negatively correlated with SF-36 scores. SF-36 might be included in the detection of pulmonary evaluation in RA patients. The relationship between thoracic HRCT findings and self-reported questionnaires in RA necessitates further studies. Disclosure of Interest None declared

Background Sjogren9s syndrome (SjS) is characterised by chronic autoimmune inflammation primarily affects the salivary and lacrimal glands. Recently, ultrasonography (USG) of major salivary glands (SG-USG) has been used to evaluate salivary glands in primary and secondary SjS. Objectives We aimed to investigate the association between the ultrasonographic scoring of major salivary glands and disease activity indexes in patientswith primary SjS. Methods Forty-two primary SjS patients fulfilling ACR-EULAR classification criteria (2002) were included. Disease activity indexes (Sjogren9s Syndrome Patients Reported Index (ESSPRI), Visual Analogue Scale (VAS), EULAR Sjogren9s Syndrome Disease Activity Index (ESSDAI)] were recorded. Major salivary glands (bilateral parotis and submandibular glands) were scored according to two different scoring system [Hocevar A. (0–48) ve Milic VD. (0–12)]. Results Demographics, clinical characteristics, disease activity indexes and SG-USG scores were summarised in table 1 and table 2. Twenty-four (57%) and25 (60%) patients had the cut-offvalues of ≥17 (Hocevar) and ≥6 (Milic USG).The patients with the scores of ≥17 (Hocevar)were found to have higher scores of ESSPRI-total (18±5 vs 14±5, p=0,01). Hocevar and Milic USG scores were shown to be higher in anti-Ro(+) SjS patients (25±10vs14±7and7±3vs4±2, p=0,01).USG scores were not found to be associated with the scores of ESSDAI, VAS and ESSPRI items. Conclusions Hocevar scoring system of major salivary glands was found to be related to patient reported activity in SjS. USG scores were associated with anti-Ro positivity. Evaluation of SG-USG might promote the diagnosis and follow-up of the SjS patients. Disclosure of Interest None declared

Background Patient-reported outcomes (PROs) are important in monitoring and making treatment decisions.Recently,we reported that the translation of“tender points” in the fourth question of the Turkish version of BASDAI was not correctly understood,and replacing this question with an entheses examination (BASDAI-Q4) decreased the score (ΔBASDAI:0.99,p Objectives We report here the results of an investigator initiated clinical trial using a self-developed mobile phone application (MPA)2 to overcome the problem of untranslability. Methods Out of 135 invited 95 axSpA patients participated.Initially,BASDAI self-report forms (BSRF) were administered.Thereafter,patients were randomized into two groups (2:1).GroupA completed a second set of BSRF after using the MPA with embedded videos defining terms and grading for each domain.GroupB completed a second set of BSRF under guidance of an inexperienced family physician (FP).A third set of BSRFs were completed by GroupB with the same FP after he went through the MPA.Afterwards,an entheses examination (EE) was performed by a blinded rheumatolgist and patients graded enthesis pain between 0–10.StandartQ4 was replaced with the EE scoring (BASDAI-Q4).Patients older than 45 years of age were excluded. Results Fifththree male (%55.7) and 42 female (%44.3)patients,with a mean disease duration of 13 years (SD=8.7)were studied.Sixtyfour and 31 patients were randomized to Groups A and B, respectively.Nine patients reported the Q4 as“not understood”.32 patients had no enthesitis on EE,but of those only 21 scored“0” for Q4 during the unassisted-PRO.Eleven reporting no enthesitis had so on EE.In GroupA,out of six“not understood” responders forQ4,five reported enthesitis after MPA assistance and four had enthesitis at the final EE.Nineteen patients had no enthesitis on physical examination,but of those only 12 scored“0” for Q4 during the unassisted PRO,and an additional nine scored“0” forQ4 after MPA assistance.Six out of seven patients reporting no enthesitis,but with enthesitis on EE reported,enthesitis after MPA assistance.In GroupB,scoring forQ4 was similar after both the unassisted- and FP9s first assistance PRO.Out of four “not understood” responders for Q4,two reported enthesitis after the second assistance of FP and both had enthesitis at the final EE.Six patients had no enthesitis on EE,but of those only4 scored“0” for Q4 during the unassisted-PRO,and an additional two scored“0” for Q4 after second FP-assistance.Two out of four patients reporting no enthesitis,but with enthesitis on EE,reported enthesitis after second FP-assistance.Mean BASDAI was significantly higher in both groups then BASDAI-Q4 (Group A=3.97±1.95 vs. 2.84±1.98, p Conclusions Mobile applications may improve the quality of collected data in cases of untranslability even in previously validated PROs. References AtagunduzP,et-al.Arthritis Rheumatol.2015;67(suppl10). https://secure.yonetimislemleri.com/asasistan/. Disclosure of Interest None declared

Background Gastrointestinal system (GI) is commonly involved in systemic sclerosis (SSc) beginning after early stages of disease. Objectives We aimed to investigate capillaroscopic findings among the SSc patients with GI involvement and malnutrition. Methods GI involvement was evaluated by UCLA SCTC GIT 2.0 questionnaire (Khanna D.) (7 multi-item; reflux, distension, soilage, diarrhea, social functioning, emotional wellbeing and constipation) in SSc patients ACR/EULAR classification criteria (2013). To report the nutrition status of the patients “malnutrition universal screening tool (MUST)” (sum of the scores of body mass index, weight loss in last 3–6 months and acute disease effect) scores were calculated. Simultaneously, nail fold video-capillaroscopy (NVC) was performed in all paatients to deterimine ealy, active late scleroderma patterns (Cutalo et al.). Results In 58 SSc patients (51 female); the mean age, duration of Raynaud9s, non-Raynaud symptom (year) and follow-up (month) were 46±13, 54±50, 10±9 and 7±7, respectively. Limited cutaneous form, positive ANA and anti-Scl70, telangiectases, dysphagia, digital ulcers, lung disease were found in 40 (71%), 48 (83%) and 21 (36%), 45 (78%), 39 (67%), 33 (57%), 23 (40%) in patients, respectively. Of the NVC patterns, early was found in 16 (28%), active was in 11 (19%), late was in 28 (48%) and normal in 3 (5%). The scores of disease activity, severity and GI were shown to be higher in patients with late NVC pattern (table-1). Of the patients with MUST score of >0 (n=10), 9 had late and 1 had early NVC pattern. Conclusions This SSc cohort predominantly had limited cutanous disease and vascular manifestations. In patients with late scleroderma pattern, severity of GI was higher similar to disease activity and severity. Undernutrition was frequently seen in patients with late pattern. NVC might be useful to predict the severity of GI and malnutrition and allow to direct the patients to required procedures earlier. Disclosure of Interest None declared

Background Severity of peripheral vascular involvement (PVI)is known as an important determinig cause of morbidity in sytemic sclerosis (SSc). Different vasodilating agents have been found to reduce severity and contribute to healing of digital ulcers (DU)in SSc. Objectives We aimed to evaluate the characteristics and capillaroscopic patterns of the patients with severe PVI under different vasodilator therapeutic regimens. Methods The patients were grouped as “severe PVI” if score of PVI is ≥2 (PVT=2,digital pitting scars; PVT=3, digital tip ulcerations and PVT=4, digital gangrene; Medsger) and “non-severe PVI” if score of PVI is ≤1 (PVI=0,no Raynaud9s; PVI=1, Raynaud9s requiring vasodilators). We included patients with severe PVI who received cyclic iloprost and bosentan and/or sildenafil and compared to non-severe PVI. Nail fold video-capillaroscopy (NVC)was assessed qualitatively (Cutalo et al., early, active and late patterns). Results Severe PVI group more frequently had diffuse cutaneous form, contractures, lung disease, anti-Scl70 positivity and high acute phase response and exposed to immunosuppressives (table-1). Scores of telangiectasia, skin, activity and severity were lower in non-severe group. NVC late pattern was frequent and early pattern was rare in severe PVI groups. Forty-one% (9/22) of patients received second oral agent for PVI. Monotherapy and combination groups had similar scores (table-2). Conclusions NVC late pattern was frequent in severe PVI group with long disease duration, exposed to intensive immunosuppresives and received specific vasodilators for PVI. Disease activity and severity were higher in severe PVI group. One third of the severe group required oral combination therapy for PVI. Monotherapy and combination groups were similar in terms of severity. NVC is a useful method to monitor digital ischemia and severe organ involvement in SSc. Disclosure of Interest None declared

Background MR Enterography (MRE), a part of the diagnosis in patients with inflammatory bowel disease (IBD), is increasingly used to exclude Crohn9s Disease (CD) in SpA patients with diarrhea. Two important retrospective studies1,2, on IBD suggest that acute and structural findings of sacroiliitis can be evaluated on MRE. But, it needs to be verified whether it really correlates with sacroiliac MRI. Objectives We aimed to determine whether assessment of sacroiliitis on MRE correlates with magnetic resonance imaging (MRI) of sacroiliac (SI) joint. Methods MREs used for screening of IBD in Axial SpA patients with chronic diarrhea and routine semi-coronal SI joint MR images were screened for the presence of acute inflammatory lesions and structural changes of the SI joint by the same radiologist in a blinded fashion to time and diagnosis. Firstly, MRE images and then MR images were evaluated on two separate occasions. Only patients with two imaging modalities with a maximum time distance of a month were evaluated. Results Forty-four patients with MRE imaging were included. Two MRE studies were excluded because of low resolution. Of those 11 patients (26%) had active inflammatory lesions involving mostly both SI joints and 3 had accompanying chronic structural changes. Ten patients (%24) in the MRE group had chronic structural changes, only. In the remaining 20 (47%) MRE evaluated patients SI joint were not affected. Twenty-five axSpA patients had both MRE and SI joint MRIs performed within a month. In 19 cases, out of 25 with both modalities the finding “no sacroiliitis” overlapped. An additional four patients had acute inflammatory lesions on both investigations. In only two patients either MRE or SI joint MRI had acute inflammatory lesions. In general, chronic structural changes overlapped in both modalities as well; Fourteen out of 25 patients with no changes and eight with chronic changes overlapped in both examinations. Both modalities differ in only three patients; Chronic changes was present in two patients in SI joint MRI and one patient in MRE only. Conclusions In SpA patients with chronic diarrhea a present MRE may substitute a conventional semi-coronal MRI of the SI joints and may hence decrease diagnostic expenses. Evaluation of MRE for the acute inflammatory and chronic structural changes of the SI joints may also have a place in the diagnostic flow in IBD patients referred by the gastroenterology clinics, as well. References Leclerc-Jacob, S., et al. The prevalence of inflammatory sacroiliitis assessed on magnetic resonance imaging of inflammatory bowel disease: a retrospective study performed on 186 patients. Alimentary pharmacology & therapeutics, 2014, 39.9: 957–962. Gotler, Jakob, et al. Utilizing MR Enterography for detection of sacroiliitis in patients with inflammatory bowel disease. Journal of Magnetic Resonance Imaging, 2015, 42.1: 121–127. Disclosure of Interest None declared

Background In patients with seronegative rheumatoid arthritis (RA) there is a difficulty to make the differential diagnosis with the spondyloarthropathies. Objectives To assess the presence of enthesitis in patients with seronegative rheumatoid arthritis in comparison with the healthy controls, patients with seropositive rheumatoid arthritis and ankylosing spondylitis. Methods In this cross-sectional study, seronegative and seropositive rheumatoid arthritis patients, who fulfilled the 2010 ACR/EULAR criteria, patients with ankylosing spondylitis and healthy controls have been assessed by grey scale and power doppler ultrasonography for the presence of enthesopathy at the achilles, plantar fascia, proximal patella, distal patella, quadriceps, tibialis anterior, triceps, common flexor and extensor tendons. Clinical assessment of the patient groups included demographic findings, health assessment questionnaire and disease activity score. Results In our study, we recruited age and sex matched 27 seronegative RA, 17 healthy controls, 20 seropositive RA and 12 ankylosing spondylitis patients. We evaluated and analysed both right and left sides of the enthesis regions separately which have been indicated in the methods section. The mean DAS28, mean ESR and mean CRP of the patients with seronegative RA were 3.6±1.28, 32.2±21.2 and 12.37±27.77 respectively (Table 1). Median of Madrid sonographic enthesitis index (MASEI) was 5 in patients with seronegative RA. 4 patients have severe scores. There were significant differences between seronegative RA and healthy controls (3, p=0.014) but no differences has been observed between seronegative RA with seropositive RA (6) and anklosing spondylitis (7) in MASEI scores. In comparison, hypoechogenicity of quadriceps tendon (16 (29.6%) vs 1 (2.5%), p=0.001), bone erosion at the quadriceps tendon attachment (9 (16.6%) vs 0, p=0.007), hypoechogenicity of triseps (13 (24%) vs 7 (17.5%), p=0.049) have been observed more frequently in patients with seronegative RA than seropositive RA. Significantly higher number of patients with bone erosion at the distal patella (10 (41.6%) v 3 (5.5%), p= Conclusions We observed that enthesis involvement was not seldom in patients with seronegative RA. Furthermore there were also similar frequency of entesis involvement in seropositive patients with RA. The value of enthesis sites evaluationfor the differential diagnosis of patients with seronegative RA should be further investigated and the assessment of enthesis sites in seronegative and seropositive RA patients can be important to detect active and chronic changes at the enthesis region. Disclosure of Interest None declared