This disease displays itself as a form of chronic inflammation where the tissue swells and becomes tender causing the tendons , ligaments or the articular capsule to the bone not to function as well as it should , causing an abnormal attachment .
The first time people hear of enthesopathy it is usually following an MRI . The term refers to a disorder of enthuses - bone attachments . Most often this condition is known to be inflammatory , or more precisely called an enthesitis . Enthesopathies are disorders of peripheral ligamentous or the muscular attachments . Examples include spondoarthropathy such as ankylosing spondylitis , plantar fasciitis , and Achilles tendinitis .
This disease displays itself as a form of chronic inflammation where the tissue swells and becomes tender causing the tendons , ligaments or the articular capsule to the bone not to function as well as it should , causing an abnormal attachment . The tissues may also start to break down as the body attacks the inflammation and the tissue becomes stretched and strained . Many people often develop inflammation because of injury , chronic stress , or autoimmune disease . Usually , the affected area becomes stiff and sore . Suffers also can experience pain , heat , and tenderness .
When treating a patient with enthesopathy , it is important that you work alongside the patient ’ s primary doctor who has diagnosed the problem . They will have conducted a physical examination and medical imaging study of the involved area of the body , along with finding out how tender and swollen the patient is , along with other signs of inflammation , bone injury , and structural defects . This will help with determining what the problem is and how to create your plan of treatment .
In most cases with enthesopathy , sufferers are required to rest , allowing the inflamed tissue a chance to recover . The patient is often prescribed some gentle physical therapy during the resting period and after the recovery to build up strength and flexibility . Good physical therapy can help patients avoid future injuries , and may involve tips and tricks to teach patients how to use their bones and joints more safely . Braces and orthotics can play a big part in a treatment plan to provide support and assistance
If you are working with a patient suffering from enthesopathy , keep in mind that there are medication that can be prescribed ; drugs to manage inflammation and pain along with medications available to treat specific conditions . Sometimes injections like steroids are necessary if a patient experiences extreme pain and swelling . The goal is to prevent further injury to the soft tissue by minimizing the amount of inflammation at the site as well as the awareness that drug side-effects could hinder the use certain orthotic devices .
The Physiological Roadmap of the Attachment of Tendon , Ligament and the Articular Capsule to Bone
When working with a patient who have an enthesopathy condition , it is important to remember the physical textbook-aspects of how the inflamed area should look and work . Think of this as a visual roadmap . The more you understand how that part of the body works , the greater success you will have in treatment .
The area where the attachment occurs to the bone is identified by four zones . Each of these zones gradually merges into adjacent zones . The furthest area from the bone is the first zone known as tendon proper . This consists of collagen fibers interspersed with fibroblasts or “ tendon cells .” As you move closer to the bone , the tendon cells are more rounded and arranged in pairs with a continuation of collagen fibers into the second zone , known as fibrocartilage . Progressing towards the third zone , the tendon cells will increase in size and become vaculated , with its surrounding substance the size of crystallization with mineral deposits . Though the fibrocartilage fibers remain unchanged , as you move into the fourth and final zone , a dark , regular band lies at the junction of fibrocartilage and calcified cartilage . This is known as the cement line .
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