Attention is drawn to the degenerative, rather than inflammatory, nature of most enthesopathies in sport. As a result diseases associated with the enthesis organ may be maximal within the bone. Less cellular than its uncalcified counterpart, this zone has an extracellular matrix that is calcified.
The fibrocartilage is also avascular, and the blood supply of the enthesis is derived largely from vessels in the peritenon and adjacent bone marrow.
Because the deep crural fascia in the lower part of the leg effectively serves as a retinaculum to reduce bowstringing and the bending that would otherwise occur at the enthesis, it too can be considered part of the enthesis organ complex.
Briefly, the fat pad is thought to facilitate the movement of tendon relative to bone, prevent tendon—bone adhesion, aid in the spread of bursal fluid and act as a space filler and immune organ Theobald et al. This has a wide variety of functions that have been considered previously Theobald et al.
These cells are associated with an extracellular matrix containing type II collagen fibers and aggrecan Fig.
The enthesis organ The enthesis organ is composed of the enthesis insertion and adjacent tissues. A distinction is made between different locations of fat at entheses, and possible functions include space-filling and proprioception.
Materials and methods Routine histology The material examined in this study is part of a long-established collection of histologically sectioned, human embryonic material housed in the Department of Human Anatomy and Embryology at the Universidad Complutense, Madrid. This structure forms a cavity called a bursa Adjacent supportive tissue or fascia - many insertions around the body are laden with fat which is a liquid and shock absorber at body temperature.
The sesamoid and periosteal fibrocartilages form the walls of the distal part of the retrocalcaneal bursa.
Finally, it has been described recently that many enthesis organ cartilages, by virtue of their intraarticular locations, rely on adjacent synovium for nourishment and lubrication in a manner identical to articular cartilages in synovial joints.
Dennis McGonagle, Michael Benjamin, in Rheumatology Sixth EditionAnatomy The enthesis is defined as the site of attachment of a tendon, ligament, joint capsule, or fascia to bone.
Consequently, they are commonly subject to overuse injuries enthesopathies that are well documented in a number of sports. Additionally, a network of fibrous septa within the heel fat pad is evident that is functionally important for compression tolerance of the pad.
There are no Sharpey fibers where fibrocartilage is present at entheses because the subchondral bone plate is too thin. The enthesis is closely integrated into the bone.
This network is anchored to the posterior aspect of the distal Achilles tendon attachment, indicating a close functional integration between the heel pad and the Achilles enthesis organ in the adult Fig.This concept of an enthesis organ has wide applicability, and an enthesis organ is seen at many other sites in the body.
Fundamentally, the development of an enthesis organ depends on the presence of either a microscopic pulley site immediately adjacent to the enthesis itself or an enthesis that is located in a pit, that is, the adjacent bone is slightly raised in comparison.
What is Enthesopathy? Enthesis Anatomy; Causes. Spondyloarthropathies.
Ankylosing Spondylitis; Reactive arthritis; Enthesis Anatomy. Entheses are part of an organ named as enthesis organ. In defining an organ, it is a group of tissues functioning together to perform specific tasks. So, enthesis organis are found in regions where.
The enthesis organ consists of the enthesis itself (at the base of the distal phalanx), sesamoid fibrocartilage in the deep surface of the extensor tendon, articular cartilage on the head of the intermediate phalanx (IP), and the intervening joint cavity (asterisk).
The attachment of the Achilles tendon is part of an ‘enthesis organ’ that reduces stress concentration at the hard–soft tissue interface. The organ also includes opposing sesamoid and periosteal fibrocartilages, a bursa and Kager's fat pad.
The function of the enthesis organ is to provide a stable anchorage to the skeleton and to minimise damage at the insertion site which is subject to high levels of physical stress.
The enthesis organ.
The enthesis organ is composed of the enthesis insertion and adjacent tissues. Where tendons and ligaments meet bone: attachment sites (‘entheses’) in relation to exercise and/or mechanical load The application of the ‘enthesis organ’ concept (a collection of tissues adjacent to the enthesis itself, which jointly serve the common function of stress dissipation) to understanding enthesopathies is considered and.Download