Report on the Second International Enthesitis Workshop

McGonagle, Dennis; Marzo‐Ortega, Helena; Benjamin, Michael; Emery, Paul

doi:10.1002/art.10841

Cited by 106 publications

(62 citation statements)

References 43 publications

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“…These observations support the hypothesis that fibrocartilage is the centrally involved anatomic structure in SpA enthesopathy (9). It is notable that in a single enthesis, with a different structure (both fibrous and fibrocartilaginous) in adjacent zones, inflammatory enthesitic changes are evident only in the entheseal zones rich in fibrocartilages.…”

Section: To the Editorssupporting

confidence: 85%

Deltoideal acromial enthesopathy in ankylosing spondylitis and in spondylarthropathies: Comment on the article by Lambert et al

Falsetti

Frediani

Acciai

et al. 2005

Arthritis & Rheumatism

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Section: To the Editorssupporting

confidence: 85%

Deltoideal acromial enthesopathy in ankylosing spondylitis and in spondylarthropathies: Comment on the article by Lambert et al

Falsetti

Frediani

Acciai

et al. 2005

Arthritis & Rheumatism

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“…We propose that the stress-dissipating role of the trabecular network at a fibrocartilaginous enthesis is complimentary to that of fibrocartilage on the soft tissue side of the attachment (3,4,22). In contrast, stress dissipation at a fibrous enthesis must be different, because not only is fibrocartilage absent, but also such attachments are characteristic of the shafts of long bones (23), i.e., regions where the mechanical integrity of the skeleton is promoted by a predominance of compact bone but the virtual absence of cancellous bone (24).…”

Section: Discussionmentioning

confidence: 99%

“…Historically, enthesitis has been viewed as a focal, insertional problem of soft tissue (4), but the associated inflammatory reaction often extensively involves the neighboring soft tissue (5). Importantly, inflammation also affects the bone, because osteitis adjacent to fibrocartilaginous entheses or next to fibrocartilaginous synovial joints is a characteristic feature of SpA (6)(7)(8).…”

mentioning

confidence: 99%

Microdamage and altered vascularity at the enthesis–bone interface provides an anatomic explanation for bone involvement in the HLA–B27–associated spondylarthritides and allied disorders

Benjamin¹,

Toumi²,

Suzuki³

et al. 2007

Arthritis & Rheumatism

136

106

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Objective. To describe the basis for enthesealassociated bone disease in the spondylarthritides, by analyzing microanatomic and histopathologic relationships between soft tissue, bone cortex, and adjacent trabeculae.Methods. Serial sections from 52 entheses were examined; these entheses encompassed small and large insertions in the upper limb (n ‫؍‬ 21), lower limb (n ‫؍‬ 27), and spine (n ‫؍‬ 4) from 60 cadavers. Enthesis microdamage (fissuring) as well as vascular and reparative changes were evaluated. Contact radiographs were used to ascertain the relationship between entheses and the trabecular network.Results. At virtually all fibrocartilaginous entheses, the deep cortical boundary was extremely thin (typically 50-600 m) or indistinguishable, and 96% of entheses had small holes in the cortical shell (typically 100-400 m wide). Such regions were frequent sites of bone formation and renewal (96%) and microdamage (31%); these changes were more common in the lower limb. The presence of blood vessels near holes in the cortical shell was common; in 85% of attachments, blood vessels were present on the soft tissue side of the enthesis. Highly orientated trabeculae were more obvious in the lower limb than the upper limb (59% versus 29%).Conclusion. The trabecular network supporting the cortical shell is an integral part of the enthesis, transferring load to an extensive skeletal region. In many cases, tendons/ligaments are anchored directly to such networks. This functional integration is associated with microdamage and repair at the hard tissue-soft tissue interface. These findings have implications for understanding bone involvement in SpA and for the SpA concept in general, especially the hypothesis that enthesis-bone architecture may be important in disease initiation.

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“…The enthesis can bear compressive, tensile, and shear forces, and it is estimated that the tensile forces at this site may be 4 times those of the tendon midsubstance. 3,4 In a musculotendinous junction tear, the enthesis is intact. Injury to the enthesis leads to bone loss at the junction and impaired function due to the weak tendon-bone interface.…”

Section: Discussionmentioning

confidence: 99%

Surgical Technique to Repair Musculotendinous Junction Tear of Supraspinatus Using Lateral-Row Anchors to Avoid Cut-Through

C้hernchujit

Parate

2017

Arthroscopy Techniques

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A musculotendinous junction tear is a rare type of rotator cuff tear. There is very little literature available on musculotendinous junction tears. We propose a technique for repair of this type of tear using lateral-row anchors. In this technique, the torn tendon is freshened and sutures are passed through the medial part of the torn tendon. When it is fixed with lateral-row anchors, the tear is reduced and tendon-to-tendon healing is seen. The enthesis and the tendon length are preserved.

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Report on the Second International Enthesitis Workshop

Cited by 106 publications

References 43 publications

Deltoideal acromial enthesopathy in ankylosing spondylitis and in spondylarthropathies: Comment on the article by Lambert et al

Deltoideal acromial enthesopathy in ankylosing spondylitis and in spondylarthropathies: Comment on the article by Lambert et al

Microdamage and altered vascularity at the enthesis–bone interface provides an anatomic explanation for bone involvement in the HLA–B27–associated spondylarthritides and allied disorders

Surgical Technique to Repair Musculotendinous Junction Tear of Supraspinatus Using Lateral-Row Anchors to Avoid Cut-Through

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