Do diseases cause entheseal changes at fibrous entheses?

Area of Science:

• Osteoarchaeology
• Paleopathology
• Skeletal Biology

Background:

• Fibrous entheses are key indicators of activity-related stress in past populations.
• The influence of disease on fibrous entheses is under-explored in osteoarchaeology.
• Understanding pathological effects is crucial for accurate behavioral inference.

Purpose of the Study:

• To review existing literature on pathological changes affecting fibrous entheses.
• To determine if diseases necessitate consideration when recording entheseal changes.
• To hypothesize potential disease mechanisms impacting fibrous entheses.

Main Methods:

• A comprehensive literature search was conducted using over one hundred terms in PubMed.
• The search aimed to identify studies linking pathological processes to entheseal changes.
• A review of anatomical structures of fibrous entheses informed the search strategy.

Main Results:

• No studies were found directly linking expected pathological processes to entheseal changes.
• A link between calcific tendinitis and cortical erosion at fibrous entheses was identified.
• The paucity of literature may stem from subtle or asymptomatic presentations in living individuals.

Conclusions:

• Pathological conditions, particularly calcific tendinitis, may need to be considered when interpreting fibrous entheses.
• Further systematic studies using advanced recording methods on skeletal remains are recommended.
• Accurate interpretation of entheseal changes is vital for inferring activity-related stress and behaviors in past populations.