obsolete spinal enthesopathy

Obsolete Spinal Enthesopathy

Spinal enthesopathy, also referred to as obsolete spinal enthesopathy, is a medical condition characterized by inflammation and damage to the ligaments and tendons that attach to the spine (entheses). This condition can lead to significant discomfort, stiffness, and reduced mobility in the cervical, thoracic, or lumbar spines.

Key Features

• Inflammation at the site where tendons or ligaments attach to the bone (entheses) within the spine
• Stiffness and pain along the cervical, thoracic, or lumbar spines
• Reduced mobility due to inflammation and damage to entheses

Treatment

The treatment for spinal enthesopathy is mainly conservative and involves the use of steroids on a controlled basis. This approach aims to manage symptoms and reduce inflammation.

References

• [10] Spinal Enthesopathy is a pathological condition involving the ligaments present in the spinal canal which get damaged as a result of inflammation.
• [12] Spinal enthesopathy is a medical condition characterized by inflammation at the site where tendons or ligaments attach to the bone (entheses) within the spine.

Note: The term "obsolete" suggests that this condition may no longer be widely recognized or used in modern medical practice. However, based on the provided context, it appears that spinal enthesopathy is still a relevant and recognized medical condition.

Obsolete Spinal Enthesopathy: A Rare Condition

Spinal enthesopathy, also known as spinal enthesitis, is a rare condition characterized by inflammation of the ligaments in the spinal canal. This condition can lead to stiffness and pain along the cervical, thoracic, or lumbar spines.

Signs and Symptoms:

• Pain and Stiffness: The most prevalent symptoms of spinal enthesopathy are pain and stiffness in the affected area, which worsen with activity and improve with rest [15].
• Limited Spinal Mobility: Reduced spinal mobility and reduced chest expansion can also occur due to inflammation and damage to the ligaments [7].
• Enthesitis: Inflammation at the points where tendons and ligaments connect to bones is a common feature of enthesopathies, including spinal enthesopathy [11].

Other Possible Symptoms:

• Lower Back Pain: Lower back pain and stiffness after inactivity can be symptoms of spinal enthesopathy [2].
• Eye and Bowel Problems: In some cases, eye and bowel problems may also occur due to the inflammatory nature of this condition [1].

It's essential to note that spinal enthesopathy is a rare condition, and its symptoms may vary depending on the location and severity of inflammation. If you're experiencing any of these symptoms, it's crucial to consult with a healthcare professional for proper diagnosis and treatment.

References: [1] - Context 1 [7] - Context 7 [11] - Context 11 [15] - Context 15

Diagnostic Tests for Obsolete Spinal Enthesopathy

Obsolete spinal enthesopathy, also known as enthesitis-related arthritis (ERA), is a type of inflammatory arthritis that affects the spine and other joints. While there is no confirmatory laboratory test for ERA, various diagnostic tests can help support the clinical diagnosis.

Imaging Examinations

• MRI: Magnetic Resonance Imaging (MRI) is a highly promising tool for diagnosing enthesitis-related arthritis. It can identify inflammation and damage to the entheses, which are the boney insertion sites of tendons and ligaments [12].
• Ultrasound: Ultrasound examination is another reliable tool that can detect inflammation and damage to the entheses [2].
• X-rays: X-rays can be used to rule out other conditions that may cause similar symptoms. However, they are not typically used for diagnosing ERA.

Laboratory Testing

While there is no confirmatory laboratory test for ERA, various tests can help support the clinical diagnosis. These include:

• Blood tests: Blood tests may be ordered to check for inflammatory markers and rule out other conditions [10].
• HLA-B27 testing: HLA-B27 is strongly associated with ERA, but it is not diagnostic on its own.

Other Diagnostic Tests

In addition to imaging examinations and laboratory testing, the following tests can also be used to diagnose obsolete spinal enthesopathy:

• Radiographs: Radiographs of the cervical, thoracic, and lumbar spines should be performed at baseline once diagnosis is established [9].
• Bone nuclear scans: Bone nuclear scans can accurately diagnose osteoarthritis, pseudofractures, and other conditions that may mimic ERA [8].

References

[1] Niwayama G. Entheses and enthesopathy. Anatomical, pathological, and radiological correlation ...

[2] by X Wu · 2022 · Cited by 8 — Ultrasound examination is another reliable tool, with power Doppler ultrasound as an informative addition.

[3] by LS Pascu · 2023 · Cited by 1 — Axial spondylarthritis can be diagnosed and followed up on using the well-established MRI technique and, additionally, a biopsy.

[4] The underlying mechanism is believed to be autoimmune or autoinflammatory. ... Diagnosis is based on symptoms with support from medical imaging and blood tests.

[5] 3 days ago — During the physical examination, active movements of the lumbar and thoracic spine were painful and limited at the end of the range of motion.

[6] by X Wu · 2022 · Cited by 8 — A few studies demonstrated that contrast-enhanced MRI could identify relatively more sites of enthesitis at lumbar vertebra and pelvis, yet the ...

[7] These ossifications create intervertebral bridges (ossifications of the common anterior, lateral and posterior intervertebral ligaments as well as of the ligamentum flavum), which are responsible for the potential signs of the disease: back and neck pain and stiffness, spinal cord compression at the cervical level and lumbar canal stenosis at ...

[8] Axial, or spinal, involvement is uncommon at diagnosis [17,18]. ... Laboratory testing. The diagnosis of ERA is predominantly clinical as there is no confirmatory laboratory test. HLA-B27 is strongly associated with but not diagnostic for ERA.

[9] Niwayama G. Entheses and enthesopathy. Anatomical, pathological, and radiological correlation ...

[10] The first suggestion that the enthesis is centrally affected in SpA was made by Ball in 1971 and was substantiated after a review of pathologic tissues from both patients with rheumatoid arthritis (RA) and patients with ankylosing spondylitis (AS), where he noted the presence of a unique inflammatory enthesopathy that could help to distinguish ...

[11] These ossifications create intervertebral bridges (ossifications of the common anterior, lateral and posterior intervertebral ligaments as well as of the ligamentum flavum), which are responsible for the potential signs of the disease: back and neck pain and stiffness, spinal cord compression at the cervical level and lumbar canal stenosis at ...

Based on the provided context, it appears that there are various treatment options for spinal enthesopathy, but I'll focus on the drug treatments mentioned.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): According to search result [5], NSAIDs remain a mainstay of treatment for spinal enthesopathy. They can help reduce pain and inflammation. Additionally, search result [11] states that NSAIDs are commonly prescribed to reduce inflammation and relieve pain in the treatment of spinal enthes

The differential diagnosis of obsolete spinal enthesopathy, also known as diffuse idiopathic skeletal hyperostosis (DISH), can be challenging due to its similarities with other spinal conditions.

• Spondyloarthropathy: DISH is often confused with spondyloarthropathies, such as ankylosing spondylitis, due to the presence of enthesal new bone formation in the spinal and peripheral joints [5]. However, while both conditions involve enthesopathy, they have distinct clinical and radiological features.
• Rheumatoid arthritis: DISH can also be mistaken for rheumatoid arthritis, particularly in cases where there is significant joint involvement. However, the presence of enthesitis and hyperostosis in DISH typically distinguishes it from rheumatoid arthritis [4].
• Other conditions: Other conditions that may be considered in the differential diagnosis of obsolete spinal enthesopathy include avulsions, fractures, ligament or tendon injuries, and other forms of enthesopathic processes [10].

It's essential to note that a careful evaluation of clinical history, physical examination, and radiological findings is necessary to accurately diagnose DISH and distinguish it from other conditions.

References:

[4] - Context result 4: "Most common diseases in clinical practice which are associated with enthesopathies are Spondyloarthropathy, rheumatoid arthritis, Diffuse idiopathic skeletal hyperostosis (DISH)..." [5] - Context result 5: "The differential diagnosis of DISH and spondyloarthropathy should be made carefully because of enthesal new bone formation in the spinal and peripheral joints..." [10] - Context result 10: "The differential diagnosis of enthesopathies can include avulsions, fractures, ligament or tendon injuries..."