Enthesopathy

Last revised by Mostafa Elfeky on 14 Jul 2023

Enthesopathy is a general term referring to a disorder affecting the site of tendon, ligament, or other soft tissue attachment to bone, i.e. the enthesis.

Enthesopathy caused by a rheumatological/inflammatory condition, e.g. an inflammatory arthritis, may be more specifically referred to as "enthesitis", although the two may be used interchangeably 1,2.

This process may also be referred to as insertional tendinopathy as there are shared imaging features 2 although strictly speaking this is just the tendon being affected without other structures of the enthesis. 

The causes of enthesopathy are broad. It may be localized and secondary to repetitive mechanical strain, or secondary to another condition which may be confined to a single system, or multisystem 1.

Enthesopathy can incorporate 2:

Chronic changes such as 2:

The affected tendon/ligament can be thickened and hypoechoic with loss of the normal fibrillary pattern. Hyperemia may be seen on color Doppler 2

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