obsolete Ankle or tarsus enthesopathy

Obsolete Ankle or Tarsus Enthesopathy

Enthesopathy affecting the ankle and tarsus, also known as ankle or tarsus enthesitis, is a condition characterized by inflammation and degeneration of the tendons, ligaments, and attachments at the sites where they connect to the bones in the foot and ankle. This condition can be caused by repetitive stress, overuse, trauma, or systemic inflammation related to arthritis.

Causes

• Repetitive stress and overuse: Activities such as running, jumping, or dancing can cause micro-trauma to the tendons and ligaments, leading to enthesopathy.
• Trauma: A sudden injury to the ankle or tarsus can cause enthesopathy.
• Systemic inflammation related to arthritis: Conditions like rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis can cause systemic inflammation that affects the tendons and ligaments, leading to enthesopathy.

Symptoms

• Pain and swelling at the site of tendon or ligament attachment
• Limited mobility and stiffness in the ankle or tarsus
• Redness and warmth around the affected area

Treatment

• Rest and ice: Avoiding activities that aggravate the condition and applying ice to reduce pain and inflammation.
• Physical therapy: Gentle exercises and stretches to improve range of motion and strengthen surrounding muscles.
• Medications: Anti-inflammatory medications or corticosteroid injections to reduce pain and inflammation.

Note: The term "obsolete" is used here to indicate that ankle or tarsus enthesopathy is not a commonly used medical term in modern practice. However, the condition itself remains relevant and can be caused by various factors.

References:

• [2] Enthesopathy is a disorder of the entheses, which are the connective tissues between bones and tendons or ligaments.
• [4] Enthesopathy describes a disease process specifically involving the enthesis, which is the insertion of tendon, ligament, fascia, muscle, or articular capsule to bone.
• [12] Enthesopathy in your ankle and tarsus, or Achilles tendon, usually affects the point where your Achilles tendon attaches to your heel bone.
• [14] Enthesopathy of the foot and ankle is a condition characterized by inflammation and degeneration of the tendons, ligaments, and attachments at the sites where they connect to the bones in the foot and ankle.

Common Signs and Symptoms of Ankle or Tarsus Enthesopathy

Ankle or tarsus enthesopathy can manifest in various ways, depending on the severity and location of the condition. Here are some common signs and symptoms:

• Pain: A sharp, stabbing, or dull ache in the ankle or foot area, which may worsen with activity or weight-bearing [1][2]
• Tenderness: The affected area may feel tender to the touch, especially at the site of tendon attachment to bone [3]
• Swelling: Localized swelling and inflammation around the ankle or foot area [4]
• Limited mobility: Reduced range of motion in the ankle or foot due to pain and stiffness [5]
• Warmth: The affected area may feel warm to the touch, indicating inflammation [6]

Specific Symptoms

In some cases, enthesopathy can cause more specific symptoms, such as:

• Heel pain: Pain or tenderness on the heel bone (calcaneus) [7]
• Mid-foot pain: Pain or discomfort in the mid-foot area, particularly in the tarsal bones [8]

Other Possible Symptoms

In rare cases, enthesopathy can cause more severe symptoms, such as:

• Tendon rupture: A complete tear of the tendon, which may require surgical intervention [9]
• Nail changes: Changes in the fingernails or toenails, such as nail cracking, pitting, or separation from the nail bed [10]

It's essential to seek medical attention if you experience any of these symptoms, especially if they persist or worsen over time. A proper diagnosis and treatment plan can help alleviate pain and prevent further complications.

References:

[1] - Context result 2 [2] - Context result 7 [3] - Context result 3 [4] - Context result 8 [5] - Context result 12 [6] - Context result 8 [7] - Context result 7 [8] - Context result 10 [9] - Context result 6 [10] - Context result 13

Enthesopathy of the ankle and tarsus, also known as Achilles tendon enthesopathy, can be diagnosed through various diagnostic tests.

• Physical Examination: A physical examination of the tendon is crucial in diagnosing Achilles tendon enthesopathy. The diagnosis is confirmed if there is tenderness of the tendon where it attaches to the heel bone. Manually bending (flexing) the ankle upwards during the examination usually makes the pain worse [3].
• Imaging Tests: Imaging tests such as ultrasonography can help determine the cause of enthesopathy in the ankle and tarsus. These tests can provide valuable information about the extent of inflammation or degeneration in the tendons and ligaments.
• Diagnostic Criteria: The clinical examination for enthesitis is sometimes equivocal, and imaging studies are helpful to identify an abnormal enthesis [4].
• Fluid Aspiration and Analysis: While not a direct diagnostic test for enthesopathy, fluid aspiration and analysis from the affected bursa can provide valuable information about the presence of inflammation or infection in the area [8].

It's worth noting that there is no single "gold standard" diagnostic test for enthesopathy. A combination of clinical evaluation, imaging studies, and sometimes laboratory tests may be used to diagnose this condition.

References:

[3] The diagnosis of Achilles tendon enthesopathy is based on a physical examination of the tendon. [4] The clinical

Based on the provided context, it appears that there are various treatment options for ankle or tarsus enthesopathy, including drug treatments.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): According to search result [2], NSAIDs can be used to reduce pain and inflammation in cases of enthesopathy. This is also mentioned in search result [3] as a treatment approach for managing the condition.

• Specifically for ankle or tarsus enthesopathy: Search result [12] suggests that NSAIDs, along with ice and rest, are commonly prescribed for 7-10 days to treat overuse enthesopathy. However, it's noted in search result [12] that NSAID use may inhibit healing by blunting the inflammatory response.

Other drug treatments: Search result [7] mentions biologic and conventional synthetic disease-modifying antirheumatic drugs (DMARDs) as potential treatment approaches for enthesopathies, including those affecting the ankle or tarsus. However, it's noted in search result [5] that there are no known disease-modifying treatments for these conditions.

First-line drug therapy: Search result [8] mentions that first-line drug therapy often includes anti-inflammatory doses of NSAIDs, if not otherwise contraindicated. This is also mentioned in search result [9], which suggests a trial of nonoperative management with NSAIDs, activity modification, shoe wear modifications, and physical therapy.

Commonly prescribed medications: Search result [10] provides data on the prevalence of various medication classes being prescribed for patients with enthesopathy. According to this data, NSAIDs are among the most commonly prescribed medications (16% for males and 8% for females).

In summary, while there is no specific "obsolete" treatment mentioned in the context, it appears that NSAIDs are a common drug treatment approach for ankle or tarsus enthesopathy, often used in conjunction with other treatments such as rest, ice, and physical therapy. However, it's essential to note that individual results may vary, and treatment plans should be tailored to each patient's specific needs.

References: [2], [3], [5], [7], [8], [9], [10], [12]

Based on the provided context, it appears that differential diagnosis for ankle or tarsus enthesopathy includes:

• Overuse and traumatic lesions [4]
• Malignant tumours of the foot and ankle [10]
• Spondyloarthropathies such as plantar fasciitis, ankylosing spondylitis, and Achilles tendinitis [14]

Additionally, other conditions that may be considered in the differential diagnosis for enthesopathy of the ankle or tarsus include:

• Calcific ligamentous enthesopathy around the ankle [5]
• Enthesitis due to injury, inflammation, or infection [1]
• Bone spurs and enthesopathic processes [12]

It's worth noting that imaging studies such as ultrasound testing and magnetic resonance imaging can be used to differentiate between these conditions and confirm a diagnosis of enthesopathy [2][12].

References:

[1] Enthesopathy is a broad term for conditions that can affect your tendons and ligaments. Enthesitis is when they get inflamed and become painful because of injury, overuse, or disease. [2] [4] ... tarsus, and ankle following a monoarticular or asymmetrically ... differential diagnosis includes enthesopathy due to overuse and traumatic lesions. [5] by A Shah · 2022 · Cited by 5 — Enthesopathy around the ankle joint could be due to overuse, injury, inflammation or infection. Calcific ligamentous enthesopathy around the ankle is a well- ... [10] Enthesopathy of ankle AND/OR tarsus. MedGen UID: ... Diagnosis. Malignant tumours of the foot and ankle. Rammelt S, Fritzsche H, Hofbauer C, Schaser KD Foot Ankle Surg 2020 Jun;26(4):363-370. Epub 2019 May 11 doi: 10.1016/j.fas.2019.05.005. PMID: 31126797. Ankle Arthroscopic Surgery. [12] Clinical diagnosis of enthesitis is based on rather non-specific clinical signs and results of laboratory tests. Imaging examinations are highly promising. Numerous publications prove that enthesitis can be differentiated from other enthesopathic processes in an ultrasound examination or magnetic resonance imaging. [14] Enthesopathy can happen at the elbow, shoulder, wrist, hip, carpus, knee, tarsus, ankle, or heel bone, among other areas. Enthesopathy may assume the state of spondyloarthropathies (joint or junction conditions of the spine) like plantar fasciitis, ankylosing spondylitis, and Achilles tendinitis. ... The differential diagnosis of enthesopathy ...