Peripheral Enthesitis (inflamed hands, knees and feet)
Definition of Enthesitis
Enthesitis is associated with:
from http://www.emedicine.com/med/topic2700.htm
- Inflammation at the point where the tendons attach to bones. This results in pain in area of the body such as: heels of feet, wrists, knees and sometimes the fingers.
Enthesitis is sometimes described as Enthesopathy, well actually Enthesitis is a type of Enthesopathy (just like beer is a type of drink). Here are some definitions for Enthesopathy :
- Abnormality of an enthesis (eg enthesitis - usually involving pain).
www.ilar.org/Glossary/Glossary_e.htm - Calcification typically of the joints, tendons and ligaments, which can result in constraints on movement.
www.xlhnetwork.org/site/Glossary.html - any rheumatic disease resulting in inflammation of entheses; eg ankylosing spondylitis, psoriatic arthritis and Reiter's disease.
www.arc.org.uk/about_arth/glossary.htm
Enthesitis is associated with:
- Ankylosing spondylitis
Occurrs in about 33% of patients - Reiter's Syndrome
Enthesitis is a common symptom in reiter's syndrome (ref A).
For information on Reiter's Syndrome click here - In my experience enthesitis and iritis have the same root causes. That is to say the same foods that trigger my enthesitis also tend to trigger my iritis.
from http://www.emedicine.com/med/topic2700.htm
Peripheral entheses and joints
* Peripheral enthesitis occurs in approximately 33% of [ankylosing spondylitis] patients. These lesions are painful and tender upon examination and may be associated with swelling of the tendon or ligament insertion.
* The most common and characteristic peripheral sites of enthesitis are the insertion of the Achilles tendon on the calcaneus and the insertion of the plantar fascia on the calcaneus. Certain anatomic areas may be more prone to enthesitis due to biomechanical stress. Other areas of involvement are listed in Peripheral enthesitis and arthropathy. Carefully examine patients for tenderness upon palpation.
* Enthesitis and synovitis account for some of the peripheral joint involvement. Peripheral joint disease occurs in 33% of patients, most commonly in the hips. Hip involvement usually occurs in the first 10 years of the disease course and typically is bilateral. Other joints may be involved, including the shoulder girdle (glenohumeral, acromioclavicular, sternoclavicular joints), costovertebral joints, costosternal junctions, manubriosternal joints, symphysis pubis, and temporal mandibular joints. Other peripheral joints uncommonly are involved and, if so, in an asymmetric oligoarticular pattern.
* Dactylitis (sausage digit) is very uncommon in patients with AS. Isolated small-joint involvement of the hands, feet, or dactylitis strongly suggests RS, ReA, PsA, or USpA.
* Destructive arthropathy may affect the hips or shoulder girdle, which may result in limited range of motion and flexion deformities.
* Peripheral enthesitis occurs in approximately 33% of [ankylosing spondylitis] patients. These lesions are painful and tender upon examination and may be associated with swelling of the tendon or ligament insertion.
* The most common and characteristic peripheral sites of enthesitis are the insertion of the Achilles tendon on the calcaneus and the insertion of the plantar fascia on the calcaneus. Certain anatomic areas may be more prone to enthesitis due to biomechanical stress. Other areas of involvement are listed in Peripheral enthesitis and arthropathy. Carefully examine patients for tenderness upon palpation.
* Enthesitis and synovitis account for some of the peripheral joint involvement. Peripheral joint disease occurs in 33% of patients, most commonly in the hips. Hip involvement usually occurs in the first 10 years of the disease course and typically is bilateral. Other joints may be involved, including the shoulder girdle (glenohumeral, acromioclavicular, sternoclavicular joints), costovertebral joints, costosternal junctions, manubriosternal joints, symphysis pubis, and temporal mandibular joints. Other peripheral joints uncommonly are involved and, if so, in an asymmetric oligoarticular pattern.
* Dactylitis (sausage digit) is very uncommon in patients with AS. Isolated small-joint involvement of the hands, feet, or dactylitis strongly suggests RS, ReA, PsA, or USpA.
* Destructive arthropathy may affect the hips or shoulder girdle, which may result in limited range of motion and flexion deformities.
