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Actually, an important real cause of altered enthesal surfaces is augmentation of the osseous base, a physiological reaction. Further, altered enthesal attachments often reveal partial-to-complete avulsion and dystrophic calcification (ossification) secondary to injury, a pathological process. Descriptively, the suffixes \u201csis,\u201d \u201cosis,\u201d and \u201casis\u201d (as appropriate grammatically) signal a general \u201caffected with\u201d state. The more preferred suffix \u201copathy\u201d suggests pathology and does not indicate cause. In clinical terms, the suffix \u201citis\u201d refers specifically to underlying inflammation, whereas suspected noninflammatory disease should be termed \u201cosis\u201d or \u201casis.\u201d From an archeological perspective, the underlying disease usually is not evident, and therefore, enthesopathy would be the more appropriate descriptor. Additionally, when describing apparent physiological responses to normal stressors, \u201cosseous surface augmentation\u201d is appropriate. Importantly, then, the suffix \u201citis\u201d is associated with defined tissue cellularity, systemic hematology, and clinical signs of heat, swelling, redness, and pain. Where the latter observations are not possible, the \u201citis\u201d inference is indirect at best. In most of the latter instances, the \u201citis\u201d suffix should be limited to a properly constructed differential diagnosis list. <\/jats:p>","DOI":"10.2460\/ajvr.24.11.0346","type":"journal-article","created":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T13:10:58Z","timestamp":1743513058000},"source":"Crossref","is-referenced-by-count":0,"title":["Can we resolve the conflation of activity-related enthesal bone changes with injury-derived enthesal reaction?"],"prefix":"10.2460","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5571-4620","authenticated-orcid":true,"given":"Dennis F.","family":"Lawler","sequence":"first","affiliation":[{"name":"Illinois State Museum, Springfield, IL"},{"name":"Center for American Archaeology, Kampsville, IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1327-6615","authenticated-orcid":true,"given":"Bruce M.","family":"Rothschild","sequence":"additional","affiliation":[{"name":"Indiana University Health, Muncie, IN"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1272","reference":[{"issue":"5","key":"B1","series-title":"J Anat","first-page":"503","article-title":"The anatomical basis for disease localization in seronegative spondyloarthropathy at entheses and related sites","volume":"199","author":"Benjamin M","year":"2001","unstructured":"Benjamin M, McGonagle D. 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