Comparative Histology of the Annular and Cruciform Pulleys

Katzman, Barry M.; Klein, David M.; Garven, Tom C.; Caligiuri, Daniel A.; Kung, J. L S

doi:10.1054/jhsb.1999.0069

Cited by 18 publications

(10 citation statements)

References 8 publications

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“…The combination of elastic component and hyaluronan has been considered to be an adaptation to vibration of the vocal fold. In the human body, the same combination of substances has also been reported in the annular and cruciform pulleys of the finger (Katzman et al. 1999), the extensor retinaculum of the wrist and ankle (Klein et al.…”

Section: Discussionsupporting

confidence: 57%

Elastic fiber‐mediated enthesis in the human middle ear

et al. 2012

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Adaptation to constant vibration (acoustic oscillation) is likely to confer a specific morphology at the bonetendon and bone-ligament interfaces at the ear ossicles, which therefore represent an exciting target of enthesis research. We histologically examined (i) the bone attachments of the tensor tympani and stapedius muscles and (ii) the annular ligament of the incudostapedial joint obtained from seven elderly donated cadavers. Notably, both aldehyde-fuchsin and elastic-Masson staining demonstrated that the major fibrous component of the entheses was not collagen fibers but mature elastic fibers. The positive controls for elastic fiber staining were the arterial wall elastic laminae included in the temporal bone materials. The elastic fibers were inserted deeply into the type II collagen-poor fibrocartilage covering the ear ossicles. The muscle tendons were composed of an outer thin layer of collagen fibers and an inner thick core of elastic fibers near the malleus or stapes. In the unique elastic fiber-mediated entheses, hyaluronan, versican and fibronectin were expressed strongly along the elastic fibers. The hyaluronan seemed to act as a friction-reducing lubricant for the elastic fibers. Aggrecan was labeled strongly in a disk-or plica-like fibrous mass on the inner side of the elastic fiber-rich ligament, possibly due to compression stress from the ligament. Tenascin-c was not evident in the entheses. The elastic fibermediated entheses appeared resistant to tissue destruction in an environment exposed to constant vibration. The morphology was unlikely to be the result of age-related degeneration.

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Section: Discussionsupporting

confidence: 57%

Elastic fiber‐mediated enthesis in the human middle ear

et al. 2012

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“…In the case of SpA, disease models based on the concept of fibrocartilage autoimmunity have recently been proposed [22,41]. However, an equally tenable view that is independent of fibrocartilage autoimmunity has been proposed [7•].…”

Section: Therapy For Enthesitismentioning

confidence: 99%

Advances in the understanding of entheseal inflammation

McGonagle¹,

Benjamin²,

Marzo‐Ortega³

et al. 2002

Curr Rheumatol Rep

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The importance of enthesitis in the pathogenesis of spondyloarthropathy (SpA) is now well recognized. Several entheses comprise more than simply the insertion site, and they are part of a complex biomechanical organ to resist shear and compression. It is also evident that tendons that wrap around bony pulleys form an integral part of joint capsules, and share, along with imaging abnormalities and histopathologic changes, common anatomic, histologic, and biomechanical features with classically defined entheses. Researchers have called these regions of tendons functional entheses. Furthermore, certain synovial joints have much in common with classic entheses--most notably those lined with fibrocartilage rather than hyaline cartilage. These observations provide a unifying anatomic basis for SpA. Enthesitis is associated with underlying osteitis, whether mechanically induced or inflammatory-related--with the extent of osteitis determined by the human leukocyte antigen-B27 gene. Until recently, there was no effective therapy for resistant enthesitis, but it is now evident that enthesitis responds well to biologic blockade with anti-tumor necrosis factor. Unraveling the pathogenic basis of enthesitis will have important implications for understanding and defining therapies in SpA.

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“…Many authors have described this pulley as having only two layers (Doyle, 1990;Lundborg and Myrhage, 1977;Sampson et al, 1991) while others have reported three layers in adults (Ellis et al, 1995;Eskeland et al, 1977;Katzman et al, 1998Katzman et al, , 1999Moutet, 2002) and in the embryonic hand (Sbernardori et al, 2000), with the inner one having a continuous synovial cellular layer (Cohen and Kaplan, 1987). A few authors have also described the presence of ''chondrocyte-like cells'' with a positive cytoplasmic reaction for S-100 protein in normal and trigger fingers (Katzman et al, 1999;Sampson et al, 1991). The presence of 'chondroid-metaplasia' has also been reported by Nakamichi and Tachibana (1998) in a histological study of the transverse carpal ligament and in the tendon sheaths in patients with De Quervain's disease (Buchman et al, 1990;Clarke et al, 1998;Meachim and Roberts, 1968).…”

mentioning

confidence: 99%

Histopathology of the A1 Pulley in Adult Trigger Fingers

Sbernardori

Bandiera

2007

J Hand Surg Eur Vol

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The histopathology of the central parts of 40 A1 pulleys from adult patients with primary trigger fingers was studied using light and transmission electron microscopes and the findings were compared with those in a control series of 10 normal A1 pulleys. The evaluation of the normal A1 pulley revealed a bi-laminar structure. The deepest layer was composed of dense normal connective tissue. The outermost layer was formed by loose connective tissue. In trigger digits, it was possible to identify a tri-laminar structure. The deepest layer was composed of irregular connective tissue, formed by small collagen fibres and abundant extracellular matrix. A considerable amount of chondroid-metaplasia was present in this layer. The middle layer contained dense, normal connective tissue with some fibrocytes. The outermost layer was formed of loose connective tissue. In conclusion, there was an additional layer in the A1 pulley in pathological cases which was not present in normal pulleys.

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Comparative Histology of the Annular and Cruciform Pulleys

Cited by 18 publications

References 8 publications

Elastic fiber‐mediated enthesis in the human middle ear

Elastic fiber‐mediated enthesis in the human middle ear

Advances in the understanding of entheseal inflammation

Histopathology of the A1 Pulley in Adult Trigger Fingers

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