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Psoriasis: Clinical Spectrum
Published in Siba P. Raychaudhuri, Smriti K. Raychaudhuri, Debasis Bagchi, Psoriasis and Psoriatic Arthritis, 2017
Chelsea Ma, Smriti K. Raychaudhuri, Emanual Maverakis, Siba P. Raychaudhuri
Psoriatic arthritis is described in other sections of this book. Evaluation of a psoriasis patient without musculoskeletal examination is considered an incomplete task. Psoriatic arthritis has been classified into five subtypes: DIP-predominant arthritis (Figure 8.2e), asymmetrical oligoarthritis and monoarthritis, symmetrical polyarthritis, predominant spondylitis, and arthritis mutilans. Dactylitis (Figure 8.2d) and enthesopathy (Figure 8.2f) are other major features seen in patients with psoriatic arthritis. In every patient of psoriasis, it is essential to look for evidence of an inflammatory arthritis, the extent or severity of arthritis, the presence of dactylitis or enthesitis, and the degree of nail involvement.
Inflammatory rheumatic disorders
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
There are two basic lesions: synovitis of diarthrodial joints and inflammation at the fibro-osseous junctions of syndesmotic joints and tendons. The preferential involvement of the insertion of tendons and ligaments (the entheses) has resulted in the term enthesopathy.
Musculoskeletal (including trauma and soft tissues)
Published in Dave Maudgil, Anthony Watkinson, The Essential Guide to the New FRCR Part 2A and Radiology Boards, 2017
Dave Maudgil, Anthony Watkinson
Are the following statements true or false? Enthesopathy may occur with: X-linked hypophosphataemia.acromegaly.Reiter’s disease.scurvy.degenerative disease.
Treatment of shoulder pathologies based on irritability: a case series
Published in Physiotherapy Theory and Practice, 2020
Kristin Somerville, Zachary Walston, Tye Marr, Dale Yake
Patient 3 was a 68-year-old male with insidious shoulder pain that started 3 to 4 months prior to the initial therapy session. He reported a progressive loss of shoulder mobility with increased pain and limitations in functional use during lifting and repetitive motions. He experienced sharp intermittent pain over his anterolateral shoulder that did not radiate below the elbow. He saw his family physician who diagnosed him with enthesopathy of the right shoulder, but no imaging was performed to determine his diagnosis. He was not taking any medication for symptoms at the time of the initial evaluation. He presented at initial evaluation with 20-degree loss of shoulder flexion, 30-degree loss of shoulder scaption, and 10-degree loss of shoulder extension. Strength of 4-/5 for flexion and abduction, 4/5 for shoulder extension, and 3 +/5 for shoulder scaption. Functional limitations included moderate difficulty with grooming and dressing, inability to lift more than 5 pounds above shoulder height, and reaching into back seat of car.
A case of advanced ankylosing spondylitis complicated with cervical myelopathy due to ossification of yellow ligament in which bone histomorphometry demonstrated delayed calcification
Published in Modern Rheumatology Case Reports, 2020
Naoki Kondo, Tatsuki Mizouchi, Kai Kubota, Naoto Endo
His physical status included multiple enthesopathy and pain, especially in bilateral insertions of the Achilles tendon. The result of a Shorber test was 0 cm, and he also demonstrated bilateral hip flexion contracture. Plain X-ray imaging revealed marked ankylosis in his sacroiliac joints (Figure 1(a)) and Computed tomography also showed complete ankylosis in his sacroiliac joint (Figure 1(b)). In the lumbar spine, ankylosis so-called “bamboo spine” and syndesmophyte was detected (Figure 1(c,d)). In the thoracic spine, ankylosis and a syndesmophyte were detected and kyphosis of the spine was observed (Figure 1(e,f)). In the cervical spine, ossification of anterior longitudinal ligament and cross-linking between vertebral columns were observed. Lateral x-ray revealed enthesopathy in the insertions of both Achilles tendons and plantar fascia (Figure 2).
Treatment of chikungunya musculoskeletal disorders: a systematic review
Published in Expert Review of Anti-infective Therapy, 2018
Lusiele Guaraldo, Mayumi Duarte Wakimoto, Heloisa Ferreira, Clarisse Bressan, Guilherme Amaral Calvet, Geraldo Castelar Pinheiro, Andre Machado Siqueira, Patrícia Brasil
Joint and periarticular involvement is often debilitating and categorized as chronic if persisting beyond 3 months after symptoms onset, and can last for months and even years [1]. Joint pain during this phase may be the result of mechanical musculoskeletal disorders or inflammatory manifestations such as synovitis and tenosynovitis. Enthesopathy may present with a fluctuating and migratory course. A few patients may develop a destructive arthropathy like psoriatic or rheumatoid arthritis. Patients may also present a variety of manifestations such as fatigue, headache, pruritus, alopecia, rash, bursitis, tenosynovitis, dysesthesia, paresthesia, neuropathic pain, Raynaud’s phenomenon, cerebellar alterations, sleep disorders, memory disorders, attention deficit, alterations mood, visual turbidity, and depression. This phase can last up to 3 years and prevalence varies among the studies [6–8].