Enthesitis and Enthesopathy

  • Medical Author:
    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

  • Medical Editor: Catherine Burt Driver, MD
    Catherine Burt Driver, MD

    Catherine Burt Driver, MD

    Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.

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Enthesitis and enthesopathy facts

  • Enthesitis is characterized by inflammation of attachment points of tendons or ligaments.
  • Achilles tendinitis and plantar fasciitis are forms of enthesitis.
  • Enthesitis can be caused by trauma injury or certain diseases that feature inflammation.
  • Symptoms of enthesitis include
    • localized pain,
    • tenderness,
    • stiffness,
    • swelling, and
    • warmth.
  • Physicians make a diagnosis of enthesitis clinically by simple examination.
  • Treatment of enthesitis includes measures that reduce inflammation and pain.

What is enthesitis?

Enthesitis is inflammation of the entheses, the specific point where tendons or ligaments attach to bone. For example, Achilles tendinitis is a form of enthesitis. Plantar fasciitis is also a form of enthesitis.

What is enthesopathy?

Enthesopathy is abnormality of the entheses, the specific point where tendons or ligaments attach to bone. Enthesopathy can be caused by injury or diseases. When the problem affects one area of the body, it is likely to be caused by injury. When the problem affects multiple areas, then underlying disorders become more likely.

What diseases are associated with enthesitis and enthesopathy?

Enthesitis can be caused by gout, psoriatic arthritis, reactive arthritis, ankylosing spondylitis (spondyloarthropathy), diffuse idiopathic skeletal hyperostosis (DISH), and rheumatoid arthritis.

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Enthesitis Symptoms and Signs

Enthesitis is inflammation of the entheses, the specific point where tendons or ligaments attach to bone. Enthesitis causes symptoms like

  • pain,
  • swelling,
  • tenderness,
  • stiffness, and
  • warmth in the areas of the affected, inflamed tendon or ligament.

This can lead to localized dysfunction of movement. For example, Achilles tendinitis is a form of enthesitis that can cause pain and stiffness in the back of the ankle. This can cause limping and inability to run or jump. Plantar fasciitis is also a form of enthesitis that causes inflammation of the bottom of the foot and can cause limping.

What are enthesopathy and enthesitis symptoms and signs?

Symptoms of enthesitis include localized pain, tenderness, stiffness, swelling, and warmth in the area of the inflamed tendon or ligament.

How do health care professionals diagnose enthesitis?

The diagnosis of enthesitis is usually diagnosed clinically by simple examination by a health care professional. Radiologic testing can sometimes demonstrate calcification or spur formation in the area if the enthesitis is chronic. MRI scanning can highlight the inflamed tissues.

What is the treatment for enthesitis?

Enthesitis is treated by measures that decrease inflammation and pain. This includes rest from activity, cold application, and anti-inflammatory medications. Physical therapy is sometimes incorporated as part of the treatment regimen.

What is the prognosis of enthesitis?

The prognosis of enthesitis depends on whether or not an injury caused it. Injuries, depending on the severity, can heal completely. Enthesitis that is caused by an inflammatory disease can be persistent but often resolves in response to treating the underlying disease.

Is it possible to prevent enthesitis?

Enthesitis that is caused by injury can be prevented by measures that avoid injury. Sometimes support braces can be helpful with certain athletic activity.

REFERENCE:

Firestein, Gary S., et al. Kelley's Textbook of Rheumatology, 9th Edition. Philadelphia, PA: Saunders, 2013.

Last Editorial Review: 2/28/2017

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Reviewed on 2/28/2017
References
REFERENCE:

Firestein, Gary S., et al. Kelley's Textbook of Rheumatology, 9th Edition. Philadelphia, PA: Saunders, 2013.

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