Enthesial fibrocartilage - bone interaction: a radiographic study of selected sites of nonsynovial peripheral enthesopathy

• Published in: Journal of musculoskeletal & neuronal interactions 2003-03, Vol.3 (1), p.89-100
• Main Authors: Voudouris, K P, Sidiropoulos, P, Vounotripidis, P, Arvanitakis, M
• Format: Article
• Language: English
• ISSN: 1108-7161

To assess radiological imaging and prevalence of pelvic (excluding sacroiliac joints), calcaneal, patellar and humeral enthesopathy (EN) in a cohort study. Outpatients attending a state hospital rheumatology clinic for a continuous 4-year period, were consecutively screened for radiographic evidence of peripheral nonsynovial EN in pelvis, ankle, knee and shoulder regions and in particular sites within these regions regardless of symptoms. Imaging and prevalence were assessed in patients suffering from a variety of myoskeletal disorders by applying either of the following two plain X-ray criteria: a) tendon and/or ligament and/or fascia ossification, b) reactive bone proliferation resulting in excrescences and/or sclerosis and/or erosions. A total of 3,670 patients were screened and a cohort of 585 patients (16%) with extraspinal peripheral EN was selected. Plain radiography provided good imaging of pelvic EN at iliac crests, greater trochanters, pubic symphysis and pubic rami, as well as of calcaneal, patellar and humeral head enthesopathic changes. Cohort recruitment by applying the two aforementioned criteria resulted in the formation of 2 groups: Group A, consisting of 169 patients (mean age in years 34 -/+ 8 SD) suffering from inflammatory myoskeletal disease represented by Seronegative Spondyloarthropathies (SSp); and Group B, including 416 patients (mean age 63 -/+ 7) suffering from degenerative/metabolic disorders classified as degenerative disease of the spine, hip or knee (70%), Diffuse Idiopathic Skeletal Hyperostosis (DISH) (11%) and rotator cuff (Rot/Cuff) syndromes (19%). Females were the predominant gender in the cohort and in Group B patients (both p