Enthesopathy

Enthesopathy
EnthesopathyPelvis.png
Enthesopathy of the pelvis likely due to ankylosing spondylitis
Specialty	Orthopedics

An enthesopathy refers to a disorder involving the attachment of a tendon or ligament to a bone. This site of attachment is known as the enthesis (pl. entheses). If the condition is known to be inflammatory, it can more precisely be called an enthesitis.

Forms

File:EnthesopathyPelvisCT.png

Enthesopathy of the pelvis likely due to ankylosing spondylitis

Enthesopathies may take the form of spondyloarthropathies (joint diseases of the spine) such as ankylosing spondylitis, plantar fasciitis, and Achilles tendinitis. Enthesopathy can occur at the shoulder, elbow, wrist, carpus, hip, knee, ankle, tarsus, or heel bone, among other regions. Further examples include:

• Adhesive capsulitis of shoulder
• Rotator cuff syndrome of shoulder and allied disorders
• Periarthritis of shoulder
• Scapulohumeral fibrositis
• Synovitis of hand or wrist
• Periarthritis of wrist
• Gluteal tendinitis
• Iliac crest spur
• Psoas tendinitis
• Trochanteric tendinitis

Diagnosis

Mainly by clinical examination and provocative tests by counter acting the muscle action.

Treatment

Experts state that the mainstay of treatment is basically passive stretching augmented with analgesics during acute attacks. Soft cushioned foot wear for plantar fasciitis and work modification are other modalities of preventing the disease progression. Rarely, calcified attachment can be removed either minimally invasive or through arthroscopy. Earlier injection of steroid as mixed with local anaesthetic at the tender spot was a widely used treatment modality. Recent advancements include injection of Platelet-rich plasma or stem cells to reduce inflammation and to promote healing.