Noninvasive Imaging in CD

CE / CME

Interactive Case Challenge 2: Integrating Noninvasive Imaging in Crohn’s Disease Management 

Physician Assistants/Physician Associates: 0.50 AAPA Category 1 CME credit

Nurse Practitioners/Nurses: 0.50 Nursing contact hour

Physicians: maximum of 0.50 AMA PRA Category 1 Credit

ABIM MOC: maximum of 0.50 Medical Knowledge MOC point

Released: March 20, 2025

Expiration: March 19, 2026

Activity

Progress
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Course Completed

Case History



Mr Burns returns in 12 weeks. The patient reports less abdominal pain, diarrhea, and fatigue. He still has intermittent bloating and occasional constipation. A treat-to-target ileocolonoscopy was done and showed mild narrowing of the ileocecal valve, but the scope was able to easily traverse the narrowing and there were fewer than 5 scattered ulcerations seen only in the last 4 cm of the ileum consistent with healing but not complete resolution. There was no evidence of significant proximal dilation or severe inflammation. His CRP decreased to 5 mg/L (upper limit of normal: 5 mg/L) and fecal calprotectin is now 275 μg/g, indicating a partial response to the intensified treatment regimen. Further monitoring should focus on symptom progression and biomarkers, with repeat ileocolonoscopy or cross-sectional imaging if clinical symptoms worsen or fail to improve. 

Based on the STRIDE-II guidelines, what is the recommended primary target for inflammatory bowl disease therapy for Mr Burns?