Enthesis Of The Hip

Ligaments attach one bone to another and thereby provide structural integrity to the skeleton.Injury to ligaments usually results from excessive force being applied.Etiology: Most forms of nonarticular pain are caused by direct trauma, repetitive-use injury, systemic inflammatory or crystal-induced diseases, or infection.

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Synonyms: Soft tissue rheumatism, overuse syndrome, bursitis; tendinitis, enthesitis.

ICD-9 Codes: Bursitis, 727.3; tendinitis, 726.9; enthesitis, 726.9.

The place where ligaments and tendons and synovial capsules insert into bone (the enthesis) may also be the site of inflammation.

Enthesitis may result from trauma but may also be associated with systemic inflammatory diseases such as the seronegative spondyloarthropathies.

Direct palpation of an inflamed tendon often generates pain.

Pain may also be elicited by forced supination and flexion of the forearm against resistance.Excess force applied may cause an avulsion fracture although more commonly the ligament will tear; this is commonly called a sprain.Sprains range in severity from mild partial tears (grade I) to more severe tears where a sound (a “pop”) might be heard, to complete disruption of the ligament with resultant laxity.A number of tendons travel through a fibrous tube or sheath.Inflammation of the lining of this sheath is known as tenosynovitis.Their function is to allow smooth gliding between adjacent surfaces and to provide some buffer against injury.Inflammation of a bursa, or bursitis, usually results from trauma (particularly, repetitive trauma), overuse, or other types of direct injury.Traumatic conditions are more common in young adults.Males are slightly more often affected than females. Cardinal Findings: Often, a focused history and physical examination can readily pinpoint the specific cause of the patient’s complaint.Tenosynovitis may result from direct trauma, repetitive-use injury, systemic inflammatory diseases, or infection.Stenosis and/or inflammation of a tendon sheath may interfere with smooth movement of the tendon.


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