Enthesopathy is a disorder of the entheses, which are the connective tissues between bones and tendons or ligaments. Enthesopathy occurs when these tissues have been damaged, due to overuse, injury or infection. It may also be caused by an inflammatory condition such as psoriatic arthritis, ankylosing spondylitis, sarcoidosis, or gout. Some research indicates that enthesopathy may develop as a result of an autoimmune disorder. Enthesopathy may develop in various parts of the body, including the shoulders, hips, elbows, wrists, knees, heels or feet. This condition is typically found in individuals over the age of 50, and is usually characterized by symptoms of severe pain and inflammation.

Symptoms of Enthesopathy

Although the location of symptoms may vary, the symptoms of enthesopathy include pain, swelling and inflammation, that most commonly occurs in peripheral joints such as foot joints, elbow and shoulder joints, or hip joints. If enthesopathy occurs in the hands or feet, it may cause the fingers or toes to swell significantly.

Diagnosis of Enthesopathy

Enthesopathy is diagnosed after a physical examination and a review of symptoms. Additional tests may be conducted to rule out any underlying conditions and may include:

  • Urinalysis
  • Blood tests
  • Joint fluid analysis
  • X-rays

High-frequency ultrasound testing is particularly effective in diagnosing enthesopathy.

Treatment of Enthesopathy

Treatment for enthesopathy includes treating any underlying causes, as well as anti-inflammatory medication to reduce pain and inflammation. Resting the connective tissue may also allow the damaged tissues to heal. Severe cases of enthesopathy may require steroid injections to relieve symptoms of pain and swelling. If conservative treatments are not effective, surgery may be recommended to drain fluid or repair damaged joints.

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