open access

Vol 76, No 2 (2017)
CASE REPORTS
Published online: 2016-09-28
Submitted: 2014-08-07
Accepted: 2014-08-27
Get Citation

Enthesopathic patterns of two South African female cadavers

N. Naidoo, L. Lazarus, K. S. Satyapal
DOI: 10.5603/FM.a2016.0061
·
Pubmed: 27714733
·
Folia Morphol 2017;76(2):326-330.

open access

Vol 76, No 2 (2017)
CASE REPORTS
Published online: 2016-09-28
Submitted: 2014-08-07
Accepted: 2014-08-27

Abstract

Enthesopathy is considered to be an osseous phenomenon, either disease-specific or bone-site specific, which occurs at the enthesis of bone. Upon routine cadaveric dissection of the glenohumeral region in two Caucasian females, enthesopathy of the right proximal humerus was observed unilaterally in both cases. Case 1 exhibited an inconsistent pattern of bony protuberances and crests dispersed across the lesser and greater tuberosities of the right humeral head. Varying degrees of ossification of the distal subscapularis muscle was also observed. Case 2 presented with a distinctively large enthesophyte that protruded supero-medially from the proximal right humerus. In addition, ossification of the distal-most aspect of the supraspinatus muscle was identified. Cases 1 and 2 were both reflective of osteophytic enthesopathy as proliferative change was clearly visible on the proximal aspect of each humerus. Whilst the presence of enthesopathies may be indicative of underlying pathology, it may prove beneficial to the field of bioarchaeology for the remodelling of lifestyles of ancient civilizations through the provision of current day variations as seen in these two case studies.

Abstract

Enthesopathy is considered to be an osseous phenomenon, either disease-specific or bone-site specific, which occurs at the enthesis of bone. Upon routine cadaveric dissection of the glenohumeral region in two Caucasian females, enthesopathy of the right proximal humerus was observed unilaterally in both cases. Case 1 exhibited an inconsistent pattern of bony protuberances and crests dispersed across the lesser and greater tuberosities of the right humeral head. Varying degrees of ossification of the distal subscapularis muscle was also observed. Case 2 presented with a distinctively large enthesophyte that protruded supero-medially from the proximal right humerus. In addition, ossification of the distal-most aspect of the supraspinatus muscle was identified. Cases 1 and 2 were both reflective of osteophytic enthesopathy as proliferative change was clearly visible on the proximal aspect of each humerus. Whilst the presence of enthesopathies may be indicative of underlying pathology, it may prove beneficial to the field of bioarchaeology for the remodelling of lifestyles of ancient civilizations through the provision of current day variations as seen in these two case studies.

Get Citation

Keywords

enthuses, enthesopathy, proximal humerus, osteophytic

About this article
Title

Enthesopathic patterns of two South African female cadavers

Journal

Folia Morphologica

Issue

Vol 76, No 2 (2017)

Pages

326-330

Published online

2016-09-28

DOI

10.5603/FM.a2016.0061

Pubmed

27714733

Bibliographic record

Folia Morphol 2017;76(2):326-330.

Keywords

enthuses
enthesopathy
proximal humerus
osteophytic

Authors

N. Naidoo
L. Lazarus
K. S. Satyapal

References (23)
  1. Baumgarten DA, Taylor AT. Enthesopathy associated with seronegative spondyloarthropathy: 99mTc-methylene diphosphonate scintigraphic findings. AJR Am J Roentgenol. 1993; 160(6): 1249–1250.
  2. Benjamin M, Evans EJ, Copp L. The histology of tendon attachments to bone in man. J Anat. 1986; 149: 89–100.
  3. Benjamin M, Kumai T, Milz S, et al. The skeletal attachment of tendons--tendon "entheses". Comp Biochem Physiol A Mol Integr Physiol. 2002; 133(4): 931–945.
  4. Benjamin M, McGonagle D. The anatomical basis for disease localisation in seronegative spondyloarthropathy at entheses and related sites. J Anat. 2001; 199(Pt 5): 503–526.
  5. Benjamin M, McGonagle D. The enthesis organ concept and its relevance to the spondyloarthropathies. Adv Exp Med Biol. 2009; 649: 57–70.
  6. Benjamin M, Toumi H, Suzuki D, et al. Evidence for a distinctive pattern of bone formation in enthesophytes. Ann Rheum Dis. 2009; 68(6): 1003–1010.
  7. Bianchi S, Martinoli C, Abdelwahab IF. Ultrasound of tendon tears. Part 1: general considerations and upper extremity. Skeletal Radiol. 2005; 34(9): 500–512.
  8. Cormick W. Enthesopathy - a personal perspective on its manifestations, implications and treatment. Australas J Ultrasound Med. 2010; 13(4): 19–23.
  9. DiGangi EA, Moore MK. Methods in Human Skeletal Biology. Elsevier, United States of America 2013: 87–88.
  10. Freemont AJ. Enthesopathies. Current Diagnostic Pathology. 2002; 8(1): 1–10.
  11. Henderson C. When hard work is disease: the interpretation of enthesopathies. Bar International Series. 2008; 1743(17).
  12. Henderson CY, Gallant AJ. Quantitative recording of enthesis. Paleopathol Newsletter. 2007; 137: 7–12.
  13. Lambert RGW, Dhillon SS, Jhangri GS, et al. High prevalence of symptomatic enthesopathy of the shoulder in ankylosing spondylitis: deltoid origin involvement constitutes a hallmark of disease. Arthritis Rheum. 2004; 51(5): 681–690.
  14. Mariotti V, Facchini F, Belcastro MG. Enthesopathies--proposal of a standardized scoring method and applications. Coll Antropol. 2004; 28(1): 145–159.
  15. McGonagle D. Imaging the joint and enthesis: insights into pathogenesis of psoriatic arthritis. Ann Rheum Dis. 2005; 64 Suppl 2: ii58–ii60.
  16. Morag Y, Jacobson JA, Miller B, et al. MR imaging of rotator cuff injury: what the clinician needs to know. Radiographics. 2006; 26(4): 1045–1065.
  17. Resnick D, Niwayama G. Entheses and enthesopathy. Anatomical, pathological, and radiological correlation. Radiology. 1983; 146(1): 1–9.
  18. Roberts AM, Peters TJ, Brown KR. New light on old shoulders: palaeopathological patterns of arthropathy and enthesopathy in the shoulder complex. J Anat. 2007; 211(4): 485–492.
  19. Shaibani A, Workman R, Rothschild BM. The significance of enthesopathy as a skeletal phenomenon. Clin Exp Rheumatol. 1993; 11(4): 399–403.
  20. Slobodin G, Rozenbaum M, Boulman N, et al. Varied presentations of enthesopathy. Semin Arthritis Rheum. 2007; 37(2): 119–126.
  21. Villotte S, Castex D, Couallier V, et al. Enthesopathies as occupational stress markers: evidence from the upper limb. Am J Phys Anthropol. 2010; 142(2): 224–234.
  22. Voudouris KP, Sidiropoulos P, Vounotripidis P, et al. Enthesial fibrocartilage - bone interaction: a radiographic study of selected sites of nonsynovial peripheral enthesopathy. J Musculoskelet Neuronal Interact. 2003; 3(1): 89–100.
  23. Zumwalt A. The effect of endurance exercise on the morphology of muscle attachment sites. J Exp Biol. 2006; 209(Pt 3): 444–454.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By  "Via Medica sp. z o.o." sp.k., Świętokrzyska 73, 80–180 Gdańsk, Poland

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl