E is for Enthesitis

April 30, 2013

Enthesitis is an inflammation of the insertion of ligaments and tendons.

Enthesitis is a condition characterized by inflammation at the site where tendons or ligaments attach to bone, known as the enthesis. The enthesis is a transitional zone where the soft tissues meet the bone, providing stability and transmitting forces between the two structures.

Enthesitis is commonly associated with spondyloarthritis, a group of chronic inflammatory diseases that primarily affect the spine and sacroiliac joints. It can also occur in other conditions such as psoriatic arthritis and reactive arthritis. Enthesitis is believed to be caused by an autoimmune reaction, where the body’s immune system mistakenly attacks its own tissues, leading to inflammation.

The symptoms of enthesitis can vary depending on the location and severity of the inflammation. Common signs and symptoms include:

  1. Pain and tenderness at the enthesis, often worsened with movement or pressure.
  2. Swelling and warmth around the affected area.
  3. Stiffness and reduced range of motion in nearby joints.
  4. Tenderness or pain that may radiate along the tendon or ligament.
  5. Possible development of bony outgrowths (enthesophytes) at the enthesis over time.

Enthesitis commonly affects areas such as the heel (Achilles tendon), bottom of the foot (plantar fascia), elbows, knees, hips, and the spine (particularly the sacroiliac joints). The severity of enthesitis can range from mild discomfort to debilitating pain that significantly impairs mobility and quality of life.

Treatment for enthesitis aims to reduce inflammation, relieve pain, and improve joint function. This typically involves a combination of non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections, physical therapy exercises to stretch and strengthen the affected area, and in some cases, disease-modifying antirheumatic drugs (DMARDs) or biologic medications to manage the underlying inflammatory condition.


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