Extended reports
Bone formers: osteophyte and enthesophyte formation are
positively associated
Rheumatology Unit, Department of Medicine,
University of Bristol, Bristol Royal Infirmary, Bristol BS2 8HW, United
Kingdom
Correspondence to: Dr Juliet Rogers.
Accepted for publication 24 October 1996
OBJECTIVE
To test the hypothesis that
enthesophyte formation and osteophyte growth are positively associated
and to look for associations between bone formation at different sites
on the skeleton so that a simple measure of bone formation could be derived.
METHODSVisual examination of 337 adult
skeletons. All common sites of either enthesophyte or osteophyte
formation were inspected by a single observer who graded bone formation
at these sites on a 0-3 scale. The total score for each feature was
divided by the number of sites examined to derive an enthesophyte and
an osteophyte score. Cronbach's 
and principal components analysis were used to identify groupings.
RESULTSEnthesophyte formation was associated
with gender (M>F) and age. There was a positive correlation between
enthesophytes and osteophytes (r = 0.65, 95% confidence
interval, 0.58 to 0.71) which remained after correction for age and
gender. Principal components analysis indicated four different
groupings of enthesophyte formation. By choosing one site from each
group a simple index of total skeletal bone formation could be derived.
CONCLUSIONSOsteophytes and enthesophytes are
associated, such that a proportion of the population can be classified
as "bone formers". Enthesophyte groupings provide some clues to
aetiopathogenesis. Bone formation should be investigated as a possible
determinant of the heterogeneity of outcome and of treatment responses
in common musculoskeletal disorders.
© 1997 by Annals of the Rheumatic Diseases
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