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Enthesitis

Inflammation where tendons and ligaments attach to bones

Inflammation where tendons and ligaments attach to bones

FieldValue
nameEnthesitis
imageJoint.svg
captionTypical joint showing the entheses
fieldrheumatology

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Enthesitis is inflammation of the entheses (singular: enthesis), the sites where tendons, ligaments and joint capsules attach to bones.

It is a type of enthesopathy, meaning any pathologic condition of the entheses, with or without inflammation. There are some cases of isolated, primary enthesitis which are very poorly studied and understood. It is known to be associated with other autoimmune diseases, like spondyloarthropathies and psoriasis (thought to often precede psoriatic arthritis). A common autoimmune enthesitis is at the heel, where the Achilles tendon attaches to the calcaneus.

It is associated with HLA B27 arthropathies, such as ankylosing spondylitis, psoriatic arthritis, and reactive arthritis.

Signs and symptoms

Early clinical manifestations are an aching sensation akin to "working out too much", and it gets better with activity. It is worse in the morning (after sleeping and not moving). The muscle insertion hurts very focally as it joins into the bone, but there is little to no pain at all with passive motion.

Symptoms include multiple points of tenderness at the heel, tibial tuberosity, iliac crest, and other tendon insertion sites.

Diagnosis

Management

  • Non steroidal anti-inflammatory drugs (NSAIDs).
  • corticosteroid injections.
  • Disease-modifying anti-rheumatic drug (DMARD).

References

References

  1. Maria Antonietta D'Agostino, MD. (June 2006). "Enthesitis". Clinical Rheumatology.
  2. (30 May 2018). "Enthesitis: Much More Than Focal Insertion Point Inflammation.". Current Rheumatology Reports.
  3. (November 2017). "Enthesitis: from pathophysiology to treatment". Nature Reviews Rheumatology.
  4. (June 2017). "Reactive Arthritis". Infectious Disease Clinics of North America.
  5. "OrthoKids - Osgood-Schlatter's Disease".
  6. "Sever's Disease". Kidshealth.org.
  7. Hendrix CL. (2005). "Calcaneal apophysitis (Sever disease)". Clinics in Podiatric Medicine and Surgery.
  8. (12 April 2017). "Tendinitis".
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This article was imported from Wikipedia and is available under the Creative Commons Attribution-ShareAlike 4.0 License. Content has been adapted to SurfDoc format. Original contributors can be found on the article history page.

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