Crohn’s disease is a chronic inflammatory disorder that can progress to obstructive and penetrating complications. Although clinical symptoms are an important component of therapy, they correlate poorly with objective measures of inflammation. The treatment targets have evolved from clinical improvement only to the addition of more objective measures, such as endoscopic mucosal healing and radiologic response, which have been associated with favorable long-term outcomes, including reduced hospitalizations, surgeries, and need for corticosteroids. There are multiple endoscopic and radiologic scoring systems that can aid in quantifying disease activity and response to therapy. These modalities and scoring tools are discussed in this article.
Key points
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Crohn’s disease (CD) is a transmural chronic inflammatory disorder that can affect any part of the gastrointestinal tract.
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Assessments of disease activity and response to therapy are essential to the management of CD.
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Clinical symptoms correlate poorly with CD activity and long-term outcomes.
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Endoscopic and radiographic responses have been associated with favorable clinical outcomes.
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There are multiple endoscopic and radiologic scoring systems that provide objective measurements of disease activity and response to therapy in CD.

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