Enthesis
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Overview
Enthesis (plural: entheses) is the point at which a tendon inserts into bone, where the collagen fibers are mineralized and integrated into bone tissue. These insertion points are commonly called Sharpey's fibers.
Classification
There are two types:
- Fibrous entheses
- Fibrocartilaginous entheses
In a fibrous enthesis, the collagenous tendon or ligament directly attaches to the bone, whilst the fibrocartilaginous enthesis displays 4 zones during the transition from tendon/ligament to bone:
- i) tendinous area displaying longitudinally oriented fibroblasts and a parallel arrangement of collagen fibres
- ii) a fibrocartilaginous region of variable thickness where the structure of the cells changes to chondrocytes
- iii) an abrupt transition from cartilaginous to calcified fibrocartilage - the so-called 'tidemark' or 'blue line'
- iv) bone
Pathology
A disease of the entheses is known as an "enthesopathy" or "enthesitis" and is characteristic of spondyloarthropathy but present in other pathology as well.
External links
- Image of enthesis at Medscape
- Enthesopathy and Soft Tissue Shadows at chiroweb.com
- Resnick D, Niwayama G (1983). "Entheses and enthesopathy. Anatomical, pathological, and radiological correlation". Radiology 146 (1): 1-9. PMID 6849029.
- iii_1/e/enthesis article at GE's Medcyclopaedia
- Origin of phrase at rheuma21st.com at rheuma21st.com
Musculoskeletal system, connective tissue: bone and cartilage | |
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| Cartilage | perichondrium, fibrocartilage callus, metaphysis
cells (chondroblast, chondrocyte) types (hyaline, elastic, fibrous) |
| Bone | ossification (intramembranous, endochondral, epiphyseal plate)
cycle (osteoblast, osteoid, osteocyte, osteoclast) types (cancellous, cortical) regions (epiphysis, metaphysis, diaphysis) structure (osteon/Haversian system, Haversian canals, Volkmann's canals, endosteum, periosteum, Sharpey's fibres, enthesis, lacunae, canaliculi, trabeculae, medullary cavity, bone marrow) shapes (long, short, flat, irregular, sesamoid) |
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
