Enthesitis SpondyloArthritis Homeopathic Treatment

 








Enthesitis is inflammation of the entheses, the sites where tendons or ligaments insert into the bone. It is an enthesopathy, a pathologic condition of the entheses. Early clinical manifestations are an aching sensation akin to "working out too much", and it gets better with activity.


Enthesopathy is an umbrella term for conditions that affect these connection points. Enthesitis is when they get inflamed and become painful because of injury, overuse, or disease.


Enthesitis is common in some forms of arthritis, including psoriatic arthritis and ankylosing spondylitis. It also can happen in some children with juvenile idiopathic arthritis (also known as juvenile rheumatoid arthritis).


It isn’t usually linked to osteoarthritis or adult rheumatoid arthritis (RA), but people with those conditions can have it.


Enthesitis occurs when an enthesis becomes inflamed. Doctors believe that this inflammation is triggered by repeated stress on an enthesis, which causes microscopic damage that builds up over time. The immune system responds to the damage by releasing proteins called cytokines, which cause the enthesis to become inflamed.


Enthesitis is a central feature of spondyloarthritis (SpA). Although enthesitis has traditionally been considered to be a focal insertional disorder, advanced imaging and pathologic findings suggest that enthesitis is a diffuse process with effects on adjacent bone and soft tissue. As a result of repeated biomechanical stress, it appears that microdamage at the enthesis triggers an inflammatory response in the synovium, leading to synovitis. Along with mechanical stress, exogenous bacteria may play a role in activating the immune response, especially in genetically predisposed individuals whose major histocompatibility locus encodes the class I molecule HLA–B27. Recent studies in animal models suggest that autoimmunity against versican and fibrocartilage proteins, and bone morphogenetic protein (BMP) signaling play roles in enthesitis development. Finally, interleukin-23 (IL-23) has been implicated in enthesitis with inflammatory effects mediated through IL-17 and tumor necrosis factor (TNF), and new bone formation driven by IL-22.



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