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Enthesitis is inflammation of the entheses (singular: enthesis), the sites where tendons, ligaments and joint capsules attach to bones. [1] [2] It is a type of enthesopathy, meaning any pathologic condition of the entheses, with or without inflammation. There are some cases of isolated, primary enthesitis which are very poorly studied and ...
[1] There are two types of entheses: fibrous entheses and fibrocartilaginous entheses. [2] [3] In a fibrous enthesis, the collagenous tendon or ligament directly attaches to the bone. In a fibrocartilaginous enthesis, the interface presents a gradient that crosses four transition zones: [4]
An enthesopathy refers to a disorder involving the attachment of a tendon or ligament to a bone. [1] This site of attachment is known as the enthesis (pl. entheses). If the condition is known to be inflammatory, it can more precisely be called an enthesitis.
Spondyloarthritis (SpA), also known as spondyloarthropathy, is a collection of syndromes connected by genetic predisposition and clinical symptoms. [1] The best-known subtypes are enteropathic arthritis (EA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), and reactive arthritis (ReA). [2]
Tendinopathy is a type of tendon disorder that results in pain, swelling, and impaired function. [2] The pain is typically worse with movement. [2] It most commonly occurs around the shoulder (rotator cuff tendinitis, biceps tendinitis), elbow (tennis elbow, golfer's elbow), wrist, hip, knee (jumper's knee, popliteus tendinopathy), or ankle (Achilles tendinitis).
[4] Other gastrointestinal disorders like Whipple's disease, celiac disease, and intestinal bypass surgery for severe obesity can also cause joint involvement. The pathogenesis of arthritis in these conditions is likely influenced by immunologic, genetic, and abnormal bowel permeability factors, though the precise mechanisms are still unknown. [4]
The effect of training on the body has been defined as the reaction to the adaptive responses of the body arising from exercise [3] or as "an elevation of metabolism produced by exercise". [4] Exercise physiologists study the effect of exercise on pathology, and the mechanisms by which exercise can reduce or reverse disease progression.
Medication challenge tests, such as the methacholine challenge test, have a lower sensitivity for detection of exercise-induced bronchoconstriction in athletes and are also not a recommended first-line approach in the evaluation of exercise-induced asthma. [13] Mannitol inhalation [14] [15] has been recently approved for use in the United States.