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EnthesitisEnthesitis is an inflammation of the entheses . It is also called enthesopathy, or any pathologic condition involving the entheses. Enthesitis is a inflammation at the insertion of a tendon, ligament or joint capsule into bone that frequently occurs in many forms of spondyloarthropathy. The most commonly affected areas are the heel (plantar fasciitis), elbow (golfer's or tennis elbow) and the Achilles tendon. It is a common clinical feature of spondyloarthropathy and is found most often in the heel or knee. It may occasionally be seen in rheumatoid arthritis, systemic lupus erythematosus, or sarcoidosis but is rare in other diseases. Enthesopathy may be due to an inflammatory condition like psoriatic arthritis or a condition due to injury or overload like plantar fasciitis. These can also be associated tendinitis or tenosynovitis in Enthesitis. Signs and symptoms of EnthesitisThe joints most often affected by psoriatic arthritis are those of the knee, ankle and feet. Usually, only a few joints are swollen at a time. Like the symptoms of psoriasis, the symptoms of Enthesitis can flare and then subside. In enthesitis, inflammation caused by recurring stress creates tender spots, and often fibrosis and calcification, at the sites where the tendons and ligaments attach to the bone. Enthesitis can also cause pain at the back of the heel, sometimes known as Achilles tendonitis, making it difficult to walk or climb stairs. Enthesitis TreatmentIn recent years, the importance of enthesitis as the unifying basis for musculoskeletal disease in ankylosing spondylitis (AS) and the related spondyloarthropathies has been recognized. NSAIDs can relieve the inflammation and pain of reactive arthritis. Some, such as ibuprofen (Advil, Motrin, others) and aspirin, are available without a prescription. The most exciting development in the therapy of enthesitis-associated diseases is anti-tumor necrosis factor inhibitors, which seem to be able to suppress enthesitis completely in a significant number of cases. The optimal use of these agents for enthesitis associated diseases remains to be defined. |
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