You are here

Article Text

Article menu
Download PDFPDF
Meeting report
Enthesitis and ankylosis in spondyloarthropathy: What is the target of the immune response?
  1. J Braun,
  2. M A Khan,
  3. J Sieper
  1. Department of Rheumatology, UK B Franklin, Free University, Berlin, Germany
  1. Professor J Braun, Department of Rheumatology, Medizinische Klinik IV, Universitätsklinikum Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germanyjbraun{at}zedat.fu-berlin.de

https://doi.org/10.1136/ard.59.12.985

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    A report from a symposium held at Klinikum Benjamin Franklin, Free University, Berlin, Germany, 25–26 February 2000

    This symposium was organised by J Braun and J Sieper (Free University, Berlin) to review the current knowledge of the anatomical, inflammatory, microbiological, and immunological events in enthesitis.

    The term “enthesopathy” is relatively new and its medical history short, but some important contributions can be listed (boxFB1).

    Figure FB1

    History of “enthesopathy” • 1966 Enthesopathy first used by Niepel •  1970 Entheses centrally affected in ankylosing spondylitis, in contrast with rheumatoid arthritis (RA; Heberden oration lecture by Ball) •  1975 Some enthesitis in sacroiliitis (François) •  1983 Syndrome of seronegative enthesopathy and arthropathy in children (Rosenberg) •  1982 Sacroiliitis starts in the subchondral bone (Shichikawa) •  1991 Enthesopathy discriminative feature of spondyloarthropathy (SpA; European Spondyloarthropathy Study Group criteria, Dougados) •  1998 Entheses more commonly affected in arthritis in SpA compared with RA (McGonagle)

    The spondyloarthropathies are among the most common inflammatory rheumatic diseases.1 In addition to the strong genetic predisposition, partly due to HLA-B27,2 there are characteristic clinical features of SpA3: inflammatory back pain often due to sacroiliitis4 and enthesitis occurring mostly at various well defined locations, predominantly of the legs, such as the Achilles tendon, the plantar aponeurosis, the knee, the trochanter regions of the femur, and several pelvic sites.5 Thus entheses are ubiquitous, resulting in a diversity of associated pathological manifestations.

    Sacroiliitis is the most common early sign of SpA.6Whether or not ligamentous and entheseal structures are affected in sacroiliac inflammation has not yet been entirely clarified. To answer some of the most critical questions an expert symposium on enthesitis was organised:

    • Why are enthesis related structures affected?

    • Is the presence of fibrocartilage essential?

    • Do we have to change the concept of enthesitis or …

    View Full Text

    Footnotes

    • Professors Braun and Sieper are supported by grants from the Bundesministerium für Forschung und Technologie.