Large enthesophytes in teenage skulls: Mechanical, inflammatory and genetic considerations

David Shahar; John Evans; Mark Sayers

doi:10.1016/j.clinbiomech.2018.02.004

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Large enthesophytes in teenage skulls: Mechanical, inflammatory and genetic considerations

Journal article

Peer reviewed

Large enthesophytes in teenage skulls: Mechanical, inflammatory and genetic considerations

David Shahar, John Evans and Mark Sayers

Clinical Biomechanics, Vol.53, pp.60-64

2018

DOI: https://doi.org/10.1016/j.clinbiomech.2018.02.004

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Abstract

biomechanical load

bone spur

Spondyloarthritis

Ankylosing spondylitis

Entheses

Background: The literature implies that large enthesophytes are exclusive to genetically predisposed individuals and to Spondyloarthropathies sufferers. Accordingly, the aim of this investigation and report was to assess the involvement of genetic predisposition, inflammatory and/or mechanical influences in the development of large enthesophytes in a sample population of teenagers presenting with large enthesophytes emanating from the external occipital protuberance. Methods: Analysis was based on four teenage males (13-16 year-old) possessing 14.5-30.5 mm enthesophytes projecting from the external occipital protuberance. This study included assessment of radiographs, MRI scans, blood-work, history, the SF-36 health survey, and the comparison of these data with the relevant literature to describe the interrelationships between the presence of enlarged external occipital protuberance, forward head protraction, active inflammation and/or genetic factors. Findings: Known genetic markers (e.g. HLA-B27) were not detected by allele-specific primers and both ESR and CRP tests were negative. Additionally, MRI analyses failed to detect active localised inflammation at the external occipital protuberance and surrounding structures. The health survey yielded normal parameters for all participants. All participants displayed significantly large Forward Head Protraction values (>40 mm), and interviews with participants and their parents indicated that concerns related to posture were prevalent since early childhood. Interpretation: This report suggests that mechanical load has an important role in enthesophyte development, irrespective the involvement of inflammatory or genetic factors.

Details

Title: Large enthesophytes in teenage skulls: Mechanical, inflammatory and genetic considerations
Authors: David Shahar (Author) - University of the Sunshine Coast - Faculty of Science, Health, Education and Engineering
John Evans (Author) - Sunshine Coast Radiology
Mark Sayers (Author) - University of the Sunshine Coast - Faculty of Science, Health, Education and Engineering
Publication details: Clinical Biomechanics, Vol.53, pp.60-64
Publisher: Pergamon
Date published: 2018
DOI: 10.1016/j.clinbiomech.2018.02.004
ISSN: 0268-0033
Organisation Unit: School of Health - High Performance Sport; University of the Sunshine Coast, Queensland; School of Health and Sport Sciences - Legacy; School of Health - Sports & Exercise Science; School of Health and Behavioural Sciences - Legacy
Language: English
Record Identifier: 99451111402621
Output Type: Journal article

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