Enthesitis is observed in up to 70% of patients with reactive arthritis, and most often manifests as tenderness and sometimes pain, with or without swelling at the entheses. The most characteristic and clinically helpful site of involvement is at the insertion of the posterior and inferior surfaces of the calcaneum (Achilles tendon and plantar fascia insertions, respectively), which can result in painful heels and difficulty on walking. Other common sites include spinal processes, ischium, iliac crest, greater femoral trochanter, tibial tubercle, and the digits (dactylitis). There can also be associated tendinitis or tenosynovitis in Enthesitis.
Enthesitis is an inflammation of the entheses . It is also called enthesopathy, or any pathologic condition involving the entheses. Pain at these points of connection is known as enthesopathy, and inflammation at these sites is known as enthesitis. Metaplasia of fibroblasts at this attachment site results in the formation of fibrocartilage. One of the primary entheses involved in inflammatory autoimmune disease is at the heel. Sometimes other family members may have the same condition or an associated condition, for example, Ankylosing Spondylitis. The regions of tendons and ligaments that make up the entheses are dynamic structures with a high capacity for tissue turnover in order to respond continually to changing mechanical factors These children are at risk of the eye condition acute uveitis but this eye condition is quite different to the one that children who have pauciarticular arthritis may develop The high rate of tissue attrition at the enthesis may partly explain why this is a common target for many diseases of the skeletal system. Heel swelling and inflammation are therefore used to help diagnose certain inflammatory autoimmune diseases, including ankylosing spondylitis
Entheses are areas where tendon and other connecting tissues - join to bone. Pain at these points of connection is known as enthesopathy, and inflammation at these sites is known as enthesitis Professors Joachim Sieper and Jurgen Braun, from Free University, Berlin, organised the meeting to review current knowledge of the anatomical, inflammatory, microbiologic, and immunologic events in enthesitis. Dactylitis, or "sausage digit," is less common than enthesitis and is found more often in reactive arthritis and psoriatic arthritis than in the other spondyloarthropathies The entheses are any point of attachment of skeletal muscles to bone , where recurring stress or inflammatory autoimmune disease can cause inflammation or occasionally fibrosis and calcification . The embryologic development of enthesis is characterized by the primitive tendon or ligament attaching to the cartilage. There is a higher prevalence of the HLA-B27 genetic marker in children who have Enthesitis Related Arthritis but, as with the rheumatoid factor antibody, a percentage of the general population who show no signs of arthritis also have this marker Acute uveitis results in a painful, red eye so it becomes quite obvious when they have this condition . For this reason, it is not necessary to be watched as carefully for eye disease
Causes of Enthesitis
The common causes of Enthesitis :
Symptoms of Enthesitis
The common symptoms of Enthesitis :
Treatnent of Enthesitis
The most common Treatnent of Enthesitis :
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