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IJAR.2020.178

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Type of Article:  Original Research

Volume 8; Issue 3.2 (August 2020)

Page No.: 7654-7659

DOI: https://dx.doi.org/10.16965/ijar.2020.178

PERIPHERAL ENTHESOPATHY: AN OSTEOLOGICAL STUDY

S. Behera 1,  S. Singh 2,  M. Sar *3.

1,2 Assistant Professor, Department of Anatomy, V.S.S.Institute of Medical Sciences & Research, Burla, Sambalpur, Odisha, India.

*3 Associate Professor, Department of Anatomy, V.S.S.Institute of Medical Sciences & Research, Burla, Sambalpur, Odisha, India.

Corresponding Author: Dr. Mamata Sar, Associate Professor, Department of Anatomy, V.S.S. Institute of Medical Sciences & Research, Burla, Sambalpur, Odisha, India. E-Mail: mamatasar@gmail.com

ABSTRACT

Introduction: Enthesis is the site of attachment of tendon or ligament to the bone. Enthesitis is characterized by erosive, inflammatory lesions that may undergo ossification. Ossified entheses are commonly described as enthesophytes. Enthesitis is a common clinical finding in spondyloarthropathies (SpA). Diffuse idiopathic skeletal hyperostosis (DISH) is another condition which is characterized by ossification of entheses, Entheseal ossifications are usually observed during our bone demonstrations to Medical students.

Objective: To describe the sites and frequency of ossification of entheses in the appendicular skeleton.

Materials and Methods:  This is an observational study conducted by examining matured and intact bones of upper and lower limbs procured from the osteology section of the Department of Anatomy, VSS Institute of medical sciences and research to find out if there is any ossification of ligaments or tendons at their attachment sites.

Results:  Entheseal ossifications were more common in bones of the lower limb in comparison to that of the upper limb.  Distal parts of the lower limb were more involved by entheseal ossification compared to the proximal parts. Ligamentum patelli (33%), achillis tendon(32%) & plantar aponeurosis (27.5%)  were the most common structures ossified and presented as bony spurs at their attachment sites to the calcaneum and tibial tuberosity. In the upper limb, most of the entheseal ossification sites were around elbow joint, like medial epicondyle, lateral epicondyle, radial tuberosity, olecranon process, and articular margin of elbow joint.

Conclusion:  In addition to the usual sites of entheseal ossification described in previous imaging studies, many new sites of involvement were detected on  gross examination of bones. This study can guide the clinicians and radiologists to focus on these unusual sites to correlate with their findings.

KEY WORDS: Enthesis, Enthesophytes, Spondyloarthropathy, DISH, Ossification, Spur.

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Cite this article: S. Behera, S. Singh, M. Sar. PERIPHERAL ENTHESOPATHY: AN OSTEOLOGICAL STUDY. Int J Anat Res 2020;8(3.2):7654-7659. DOI: 10.16965/ijar.2020.178