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出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2014/05/03 00:52:31」(JST)
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Enthesitis |
Classification and external resources |
Typical Joint showing Enthesis
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DiseasesDB |
18256 |
Enthesitis is inflammation of the entheses, the sites where tendons or ligaments insert into the bone.[1][2] It is also called enthesopathy, or any pathologic condition involving the entheses. The entheses are any point of attachment of skeletal muscles to the bone, where recurring stress or inflammatory autoimmune disease can cause inflammation or occasionally fibrosis and calcification. One of the primary entheses involved in inflammatory autoimmune disease is at the heel, particularly the Achilles tendon.
It is associated with HLA B27 arthropathies like ankylosing spondylitis, psoriatic arthritis, and reactive arthritis (Reiter's syndrome).[3][4] Symptoms include multiple points of tenderness at the heel, tibial tuberosity, iliac crest, and other tendon insertion sites.
Images
Sagittal magnetic resonance images of ankle region: psoriatic arthritis. (a) Short tau inversion recovery (STIR) image, showing high signal intensity at the Achilles tendon insertion (enthesitis, thick arrow) and in the synovium of the ankle joint (synovitis, long thin arrow). Bone marrow oedema is seen at the tendon insertion (short thin arrow). (b,c) T1 weighted images of a different section of the same patient, before (panel b) and after (panel c) intravenous contrast injection, confirm inflammation (large arrow) at the enthesis and reveal bone erosion at tendon insertion (short thin arrows).
Sources
- ^ Maria Antonietta D'Agostino, MD, Ignazio Olivieri, MD. (June 2006). Enthesitis 20 (3). Clinical Rheumatology. pp. 473–486. doi:10.1016/j.berh.2006.03.007.
- ^ The Free Dictionary (2009). "Enthesitis". Retrieved 2010-11-27.
- ^ Bauman C, Cron RQ, Sherry DD, Francis JS. (March 1996). "Reiter syndrome initially misdiagnosed as Kawasaki disease". The Journal of Pediatrics 128 (3): 366–9. doi:10.1016/S0022-3476(96)70283-4. PMID 8774506.
- ^ American College of Physicians. Medical Knowledge Self-Assessment Program (MKSAP-15): Rheumatology. "The Seronegative Spondyloarthropathies." 2009, ACP. Pg. 29-30. [1]
Soft tissue disorders / Rheumatism / Connective tissue arthropathy (M65–M79, 725–728)
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Capsular joint |
Synoviopathy |
- Synovitis/Tenosynovitis
- Calcific tendinitis
- Stenosing tenosynovitis
- Trigger finger
- DeQuervain's syndrome
- Transient synovitis
- Ganglion cyst
- osteochondromatosis
- Synovial osteochondromatosis
- Plica syndrome
- villonodular synovitis
- Giant cell tumor of the tendon sheath
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Bursopathy |
- Bursitis
- Olecranon
- Prepatellar
- Trochanteric
- Subacromial
- Achilles
- Retrocalcaneal
- Ischial
- Iliopsoas
- Synovial cyst
- Calcific bursitis
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Noncapsular joint |
Ligamentopathy |
- Ligamentous laxity
- Hypermobility
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Enthesopathy/Enthesitis
(and general tendinopathy) |
upper limb |
- Adhesive capsulitis of shoulder
- Impingement syndrome Rotator cuff tear
- Golfer's elbow
- Tennis elbow
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lower limb |
- Iliotibial band syndrome
- Patellar tendinitis
- Achilles tendinitis
- Calcaneal spur
- Metatarsalgia
- Bone spur
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other/general: |
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Nonjoint |
Fasciopathy |
- Fasciitis: Plantar
- Nodular
- Necrotizing
- Eosinophilic
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Fibromatosis/contracture |
- Dupuytren's contracture
- Plantar fibromatosis
- Aggressive fibromatosis
- Knuckle pads
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noco (arth/defr/back/soft)/cong, sysi/epon, injr
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anat (h/n, u, t/d, a/p, l)/phys/devp/hist
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noco (m, s, c)/cong (d)/tumr, sysi/epon, injr
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Inflammation
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Acute |
Plasma derived mediators |
- Bradykinin
- complement
- coagulation
- Factor XII
- Plasmin
- Thrombin
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Cell derived mediators |
preformed: |
- Lysosome granules
- biogenic amines
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synthesized on demand: |
- cytokines
- eicosanoids
- Leukotriene B4
- Prostaglandins
- Nitric oxide
- Kinins
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Chronic |
- Macrophage
- Epithelioid cell
- Giant cell
- Granuloma
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Processes |
Traditional: |
- Rubor
- Calor
- Tumor
- Dolor (pain)
- Functio laesa
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Modern: |
- Acute-phase reaction/Fever
- Vasodilation
- Increased vascular permeability
- Exudate
- Leukocyte extravasation
- Chemotaxis
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Specific locations |
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UpToDate Contents
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English Journal
- Up-regulation of fatty acid oxidation in the ligament as a contributing factor of ankylosing spondylitis: A comparative proteomic study.
- Xu WD1, Yang XY2, Li DH1, Zheng KD3, Qiu PC3, Zhang W3, Li CY3, Lei KF3, Yan GQ4, Jin SW5, Wang JG6.
- Journal of proteomics.J Proteomics.2015 Jan 15;113:57-72. doi: 10.1016/j.jprot.2014.09.014. Epub 2014 Oct 2.
- OBJECTIVES: The present study first utilized a standardized shotgun proteomic analysis method to determine differences in protein expression of fibroblasts in the ligament between AS patients and healthy controls.METHODS: Proteins extracted from primarily cultured FLLs from 35 AS patients and 10 nor
- PMID 25281561
- High-resolution MRI assessment of dactylitis in psoriatic arthritis shows flexor tendon pulley and sheath-related enthesitis.
- Tan AL, Fukuba E, Halliday NA, Tanner SF, Emery P, McGonagle D.
- Annals of the rheumatic diseases.Ann Rheum Dis.2015 Jan;74(1):185-9. doi: 10.1136/annrheumdis-2014-205839. Epub 2014 Sep 26.
- OBJECTIVE: Dactylitis is a hallmark of psoriatic arthritis (PsA) where flexor tenosynovitis is common. This study explored the microanatomical basis of dactylitis using high-resolution MRI (hrMRI) to visualise the small entheses around the digits.METHODS: Twelve patients with psoriatic dactylitis (4
- PMID 25261575
- Psoriatic Arthritis for the Dermatologist.
- Tintle SJ1, Gottlieb AB2.
- Dermatologic clinics.Dermatol Clin.2015;33(1):127-148. doi: 10.1016/j.det.2014.09.010.
- Psoriatic arthritis (PsA) is a chronic, progressive, inflammatory spondyloarthropathy that affects approximately one-third of patients with all types of psoriasis. Dermatologists are in a unique position to recognize early symptoms of PsA, initiate appropriate therapy, and prevent development of fur
- PMID 25412788
Japanese Journal
- 血清炎症反応陰性脊椎関節炎患者の診断におけるFGD-PET/CTの有用性
- Utility of magnetic resonance imaging when following up sacroiliitis in enthesitis-related arthritis
- PAGNINI Ilaria,SAVELLI Sara,FONDA Claudio,MARINO Achille,CIMAZ Rolando,SIMONINI Gabriele
- Modern rheumatology 22(6), 951-952, 2012-11-01
- NAID 10031127257
- Frequency of enthesitis in apparently healthy Japanese subjects detected by ^<18>F FDG-PET/CT
- TANIGUCHI Yoshinori,KUMON Yoshitaka,OHNISHI Takenao,NOGAMI Munenobu,TANI Toshikazu,OGAWA Yasuhiro,SUGIURA Tetsuro,TERADA Yoshio
- Modern rheumatology 22(6), 939-941, 2012-11-01
- NAID 10031127254
Related Links
- Enthesitis is irritability of soft tissues (muscles, tendons or ligaments) where it enter into the bones. It is caused by joint disease and is the main sign of spondyloarthritis. It is also linked to diffuse idiopathic skeletal hyperostosis ...
- Entheses are sites of tendinous or ligamentous attachments to the bone. Enthesitis is indicative of inflammation at the sites. ... Question: What Is Enthesitis? If you have seen the words entheses, enthesitis or enthesopathy in your x ...
Related Pictures