Patellar tendinosis (jumper's knee): findings at histopathologic examination, US, and MR imaging. Victorian Institute of Sport Tendon Study Group.

Khan, Khalid; Bonar, Fiona; Desmond, Patricia; Cook, Jillianne Leigh; Young, David; Visentini, P; Fehrmann, M. W.; Kiss, Zoltan S.; O’Brien, PJ; Harcourt, Peter; Dowling, Richard; O’Sullivan, Richard; Crichton, Ken; Tress, Brian M.; Wark, John D.

doi:10.1148/radiology.200.3.8756939

Cited by 366 publications

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“…We selected these three fields from the central portion of the width and length of the tendon, and photographed each. Using these images, the pathologist assessed tendinopathy based on the three most consistent and characteristic histologic features reported in diseased human and animal tendons: cellularity of fibroblasts, cell nucleus shape, and collagen fiber organization [2,12,23,27]. The pathologist manually counted the number of fibroblast nuclei from the photographs.…”

Section: Methodsmentioning

confidence: 99%

Tendinosis-like Histologic and Molecular Changes of the Achilles Tendon to Repetitive Stress: A Pilot Study in Rats

Cho

Hwang

Lee

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Tendinopathy (pain and tendon degeneration) is associated with repetitive use and mechanical overload. However, the etiology of tendinopathy remains unclear. Clarification of histologic and molecular changes of tendon to repetitive stress could provide better understanding of Achilles tendon disorders related to repetitive stress. Questions/Purposes We asked whether repetitive stress simulating overuse of the Achilles tendon induced (1) histologic changes in rats similar to tendinosis (increased cellularity of fibrocytes, increased disorganization of collagen fiber, and increased roundness of the nucleus of the fibrocyte), (2) increased collagen Type III occurrence, and (3) increased inducible nitric oxide synthase (iNOS) expression. Methods We used an exercise protocol simulating repetitive, jerky, eccentric contraction of the triceps surae in 15 rats. We conducted the exercise for 2 hours per day, three times per week using the right rear legs only and the left legs as internal controls. We harvested Achilles tendons after either 2, 4, or 6 weeks of exercise, and evaluated changes in tendon thickness, fibrocyte count, collagen fiber arrangement, collagen fiber type, and occurrence of iNOS. Results Exercised Achilles tendons showed increased cellularity of fibrocytes at 4 and 6 weeks of exercise, and disorganized collagen fiber arrangement at 6 weeks of exercise. There was a trend for Type III collagen occurrence being greater in experimental groups. Expression of iNOS increased after 2 and 4 weeks of exercise when compared with that of the controls, but decreased after 6 weeks. Conclusions These observations suggest repetitive, synchronized, passive, and jerky exercise induced by electrical stimulation can lead to the tendinosis-like changes in the Achilles tendons in rats with imbalance between synthesis and degeneration after 4 weeks of exercise. Clinical Relevance This newly designed exercise protocol may be used to design an animal model of Achilles tendon overuse. With this model, therapeutic interventions of tendinopathy could be analyzed by investigation of tendon biology and response in terms of histologic and molecular changes.

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Section: Methodsmentioning

confidence: 99%

Tendinosis-like Histologic and Molecular Changes of the Achilles Tendon to Repetitive Stress: A Pilot Study in Rats

Cho

Hwang

Lee

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…Como o resultado histopatológico de tendões com tendinopatia patelar demonstra degeneração do colágeno, com desorientação das fibras, aumento de substância mucóide e ausência de células inflamatórias, isso nos permite dizer que as tendinopatias patelares são, em verdade, tendinoses patelares, pelo menos na grande maioria dos casos (22) . …”

Section: Patologiaunclassified

“…Com o uso contínuo do joelho em atividades físicas, a dor pode progredir, tornando-se freqüente durante as atividades, interferindo significativamente com o desempenho atlético (24) . Em alguns casos, pode evoluir, tornandose permanente, mesmo em repouso, manifestando-se como dor noturna que perturba o sono (19,22) . Outra queixa comum é a dor referida pelo paciente quando permanece com o joelho flexionado por longo período e ao subir e descer escadas (25) .…”

Section: Avaliação Clínicaunclassified

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Tendinopatia patelar

Cohen¹,

Ferretti²,

Marcondes³

et al. 2008

Rev. bras. ortop.

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RESUMOA tendinopatia do patelar ou jumper's knee (joelho do saltador) é uma afecção que acomete freqüen-temente atletas praticantes de atividades de salto ou aquelas que exigem força de impacto repetitivo. Histologicamente, a sobrecarga excessiva no tendão pode provocar alterações na matriz extracelular, resultando em pequenas lesões que, cronicamente, poderão levar a um quadro de tendinose, principalmente na região do pólo inferior da patela. A dor na região anterior do joelho é o primeiro sintoma relatado pelo paciente portador dessa afecção. Seu início é insidioso e gradual, principalmente após atividade física, mas, com a progressão da doença, pode tornar-se freqüente durante ou já no início da

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“…Aunque en nuestro trabajo no se encuentran resultados claros (en realidad no fue diseñado para realizar un análisis textural) respecto de los cambios observados en la ecografía del tendón, hay abundante literatura científica en la que se analizan los cambios en la imagen ecográfica en presencia de patología, acompañados o no de sintomatología dolorosa (Khan et al, 1996(Khan et al, , 1998(Khan et al, , 1999(Khan et al, y 2005Cook et al, 2004;Martí-nez-Payá et al, 2005a y 2008. La imagen ecográfica tendinosa disminuye en ecogenicidad (disminuye su nivel de gris), sería de una gran utilidad en la prácti-ca clínica el poder controlar la evolución y efectividad de las distintas modalidades terapéuticas de una forma sencilla y fiable.…”

Section: Discussionunclassified

El análisis textural mediante las matrices de co-ocurrencia (GLCM) sobre imagen ecográfica del tendón rotuliano es de utilidad para la detección cambios histológicos tras un entrenamiento con plataforma de vibración. (Textural Analysis by Means of a Grey Level Co-Occurrence Matrix Method on Patellar Tendon Ultrasonography is Useful for the Detection of Histological Changes after Whole-Body Vibration Training)

Ríos-Díaz¹,

Martínez-Payá²,

Aledo³

2009

CCD

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C C D 91 ResumenIntroducción: Las matrices de co-ocurrencia del nivel de gris (GLCM) son útiles para el análisis textural de imágenes ya la discriminación de patrones pero hasta ahora no se han aplicado sobre imágenes ecográficas del tendón. Objetivo: Análisis textural ecográfico del tendón rotuliano. Método: Estudio longitudinal analítico con 16 sujetos (8 mujeres y 8 hombres) jóvenes, sanos y sedentarios entrenados con una plataforma de vibración vertical (Fitvibe Medical) 2 días x 14 semanas. Se tomaron cortes ecográficos transversales del tendón rotuliano antes y después del entrenamiento con un ecógrafo Sonosite-180 (Lineal 5-10 MHz). Mediante el algoritmo GLCM de Image J v1.38 se calcularon las variables texturales Uniformidad (ASM), Contraste, Correlación, Homogeneidad (IDM) y la Entropía para cuatro orientaciones (0º, 90º, 180º y 270º) y tres distancias (d=1, 5 y 10 px). Se aplicó la prueba de Wilcoxon (i.c.95%) para muestras relacionadas (SPSS 15.0). Resultados: la Entropía (d=5) fue la más sensible a los cambios texturales; quizá la variable ASM, pueda resultar también de interés junto con el Contraste. Conclusiones: Ante la falta de referencias con el uso de la GLCM en el análisis textural de ecografía de tendón son necesarios más aná-lisis que estudien cómo afectan los distintos parámetros a las variables texturales, cómo se relacionan entre sí y cuáles pueden ser los mejores ajustes del algoritmo para detectar cambios en el patrón textural.Palabras clave: Matrices de co-ocurrencia de nivel de gris, textura, tendón ecografía, vibración de cuerpo completo. AbstractIntroduction: Co-occurrence grey level matrix (GLCM) is a textural analysis method that have been useful to discriminate patterns, but no used on tendon ultrasound image. Objective: Textural analysis of patellar tendon ultrasonograph. Method: Longitudinal analytic study with 16 subjects (8 women and 8 men) young, healthy and sedentary people with training by means wholebody vibration platform (Fitvibe Medical) for 2 days x 14 weeks. Cross-sectional of patellar tendon ultrasonographics were taken with a Sonosite-180 ultrasonograph (L 5-10 MHz). By means GLCM algorithm of Image J v1.38 it were calculated five textural parameters: Uniformity (ASM), Contrast, Correlation, Homogeneity (IDM) and Entropy in four orientations (0º, 90º, 180º and 270º) and three distances between pixels (d=1, 5 and 10 pixels). Wilcoxon test (C.I. 95%) for related samples was applied (SPSS 15.0). Results: Entropy (d=5) was the most sensible to detect textural changes; perhaps ASM and Contrast can be also useful. It seems that distances between pairs of pixels that the algorithm uses affects the results. Conclusions: The use of GLCM in the textural analysis of tendon ultrasonography is innovating and it appears like a useful tool as much to evaluate the histological evolution of tendon tissue, like coming up and detecting future pathologies precociously. But more analyses will be necessary to study how different parameters affect texture and how they are related to each...

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Patellar tendinosis (jumper's knee): findings at histopathologic examination, US, and MR imaging. Victorian Institute of Sport Tendon Study Group.

Abstract: Jumper's knee is characterized by consistent changes at MR imaging, US, and histopathologic examination and is appropriately described as patellar tendinosis.

Cited by 366 publications

References 0 publications

Tendinosis-like Histologic and Molecular Changes of the Achilles Tendon to Repetitive Stress: A Pilot Study in Rats

Tendinosis-like Histologic and Molecular Changes of the Achilles Tendon to Repetitive Stress: A Pilot Study in Rats

Tendinopatia patelar

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