Enthesis

WikiDoc Resources for Enthesis
Articles
Most recent articles on Enthesis Most cited articles on Enthesis Review articles on Enthesis Articles on Enthesis in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Enthesis Images of Enthesis Photos of Enthesis Podcasts & MP3s on Enthesis Videos on Enthesis
Evidence Based Medicine
Cochrane Collaboration on Enthesis Bandolier on Enthesis TRIP on Enthesis
Clinical Trials
Ongoing Trials on Enthesis at Clinical Trials.gov Trial results on Enthesis Clinical Trials on Enthesis at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Enthesis NICE Guidance on Enthesis NHS PRODIGY Guidance FDA on Enthesis CDC on Enthesis
Books
Books on Enthesis
News
Enthesis in the news Be alerted to news on Enthesis News trends on Enthesis
Commentary
Blogs on Enthesis
Definitions
Definitions of Enthesis
Patient Resources / Community
Patient resources on Enthesis Discussion groups on Enthesis Patient Handouts on Enthesis Directions to Hospitals Treating Enthesis Risk calculators and risk factors for Enthesis
Healthcare Provider Resources
Symptoms of Enthesis Causes & Risk Factors for Enthesis Diagnostic studies for Enthesis Treatment of Enthesis
Continuing Medical Education (CME)
CME Programs on Enthesis
International
Enthesis en Espanol Enthesis en Francais
Business
Enthesis in the Marketplace Patents on Enthesis
Experimental / Informatics
List of terms related to Enthesis

Overview

Enthesis (plural: entheses) is the point at which a tendon inserts into bone, where the collagen fibers are mineralized and integrated into bone tissue. These insertion points are commonly called Sharpey's fibers.

Classification

There are two types:

• Fibrous entheses
• Fibrocartilaginous entheses

In a fibrous enthesis, the collagenous tendon or ligament directly attaches to the bone, whilst the fibrocartilaginous enthesis displays 4 zones during the transition from tendon/ligament to bone:

• i) tendinous area displaying longitudinally oriented fibroblasts and a parallel arrangement of collagen fibres
  
• ii) a fibrocartilaginous region of variable thickness where the structure of the cells changes to chondrocytes
  
• iii) an abrupt transition from cartilaginous to calcified fibrocartilage - the so-called 'tidemark' or 'blue line'
  
• iv) bone

Pathology

A disease of the entheses is known as an "enthesopathy" or "enthesitis" and is characteristic of spondyloarthropathy but present in other pathology as well.

External links

• Image of enthesis at Medscape
• Enthesopathy and Soft Tissue Shadows at chiroweb.com
• Resnick D, Niwayama G (1983). "Entheses and enthesopathy. Anatomical, pathological, and radiological correlation". Radiology 146 (1): 1-9. PMID 6849029.
• iii_1/e/enthesis article at GE's Medcyclopaedia
• Origin of phrase at rheuma21st.com at rheuma21st.com