Role of infection in the etiopathogenesis of enthesopathies

Data of contemporary literature focuses on enthesopathies. The article describes the issues of etiopathogenesis, clinic, diagnosis, treatment and prevention. The area of enthesis becomes a “weak link” in the apparatus of the periarticular tissues, where under excessive load micro- and macroscopic lesions occur, which subsequently lead to inflammation. Inflammation of the enthesis enhances the degeneration of adjacent tissues of the tendons, ligaments, cartilage, bone. The causes of enthesopathy are congenital bone abnormalities, osteochondrosis leading to radicular syndrome (compression of the spinal nerves), microtrauma of ligaments and tendons, metabolic disorders (for example, with osteoporosis and gout), severe prolonged physical activity, various endocrine and infectious diseases, and also autoimmune and inflammatory joint damage. The question of the etiopathogenesis of the disease remains open, as a result of which there is no pathogenetically substantiated treatment. Despite the variety of medical devices and physiotherapeutic procedures, the treatment results remain unsatisfactory, there is a high percentage of relapses and a chronic process. Inflammatory and degenerative-dystrophic damage to the enthesis is attracting increasing attention, as it represents one of the peculiar groups of diseases of the bone-ligament-tendon complex and makes a significant contribution to the clinical picture and pathology.