Objective: Crohn’s disease is often difficult to diagnose. The combined score of visceral fat area/subcutaneous fat area (VFA/SCFA) >0.63 and a long segment (LS) ≥3 cm has previously been used to differentiate between Crohn’s disease and tuberculosis. We investigated whether this score identifies only Crohn’s disease and differentiates it not only from tuberculosis but also from other etiologies.

Methods: This was a retrospective analysis of prospectively maintained data at Peerless Hospital and B.K. Roy Research Centre, Kolkata, from June 2023 to January 2024. A total of 31 patients were included (15 diagnosed with Crohn’s disease, 16 diagnosed with other etiologies). Contrast-enhanced computed tomography (CECT) abdomen was performed in all clinically suspected patients, and VFA/SCFA was calculated at the level of the L4–L5 vertebrae. LS was also measured. Each patient was followed up for one year. The chi-square test was used to determine statistical significance, using MedCalc version 15.8 software. We compared the results with other radiologically applicable scores.

Results: The combined score of 2, using VFA/SCFA >0.63 and LS ≥3 cm, showed a p-value of 0.0001 and was significantly associated with the diagnosis of Crohn’s disease in our study.

Conclusion: The combined score of VFA/SCFA >0.63 and LS ≥3 cm is a useful tool for identifying Crohn’s disease and may serve as an additional marker for the condition.