Do diseases cause entheseal changes at fibrous entheses?

Abstract

Fibrous entheses have been widely used to study activity-related stress to infer behavioural patterns in past populations. Unlike their fibrocartilaginous counterparts, the effect of disease processes has been less widely discussed in the osteoarchaeological literature. This study uses a literature review to ascertain whether specific pathological changes should be taken into account when recording fibrous entheses. Due to the anatomical structure of fibrous entheses it was hypothesised that diseases which affect the structure of bone or the periosteum might be a factor in causing entheseal changes. A search of over one hundred terms was performed in PubMed with no year range stipulated, but no papers were found which related to entheseal changes caused by any of the expected pathological processes. The paucity of literature might be due to lack of symptoms in living individuals, it is therefore suggested that a systematic study of skeletal remains is performed using recently developed recording methods to determine if pathological conditions need to be taken into account when recording entheseal changes to study activity-related stress. The search did highlight a link between calcific tendinitis and cortical erosion at fibrous entheses, and it is recommended that this is taken into account when interpreting entheseal changes in past populations.

Gendered division of labor in a Celtic community? A comparison of sex differences in entheseal changes and long bone shape and robusticity in thepre‐Romanpopulation of Verona (Italy, third–first centuryBC)

“…Although the focus of this study is the estimation of differences in physical activity between the sexes in the past, one needs to first take into account the multifactorial etiology of ECs. Besides biomechanical factors, other relevant variables include age, body size, pathological conditions, hormonal and probably genetic factors (Henderson, 2013; Henderson & Nikita, 2016; Jurmain, Cardoso, Henderson, & Villotte, 2012; Milella et al, 2012; Weiss, Corona, & Schultz, 2012; Wilczak, 1998). The effect of hormonal and genetic factors on ECs in our sample cannot be tested at the moment and their influence on our results accordingly needs to be kept as a possibility.…”

Osteoarthritis, entheses, and long bone cross-sectional geometry in the Andes: Usage, history, and future directions

“…Further, these regions are part of an "enthesis organ complex," dissipating stress at the bony interface away from the attachment site. Hence, abnormal changes (e.g., diffuse idiopathic skeletal hyperostosis (DISH), synovitis, bursitis) may also result as part of the complex system of soft and hard tissues within the enthesis organ complex (Benjamin et al, 2002(Benjamin et al, , 2006Henderson, 2013;Schrader, 2019).…”

A Test of the Effectiveness of the Coimbra Method in Capturing Activity‐induced Entheseal Changes

“…This lack of direct association between activity and ECs has been attributed to the fact that a combination of factors, such as age, body mass, sex, metabolism, genetic predisposition and certain pathological conditions, also contribute to EC development (e.g. Benjamin & McGonagle, 2001;Henderson, 2008Henderson, , 2013Jurmain et al, 2011;Niinimäki, 2011;Milella et al, 2012;Weiss et al, 2012). Indeed, several studies have found that age is the primary factor affecting ECs with older individuals generally exhibiting more pronounced changes (e.g.…”