Connective Tissue Review Flashcards
What type of connective tissue are tendons?
Dense regular connective tissue
What is tendonitis?
Where small tears occur in a tendon leading to localised inflammation
What are the common causes of tendonitis?
Overuse, collagen disorders and renal dialysis
What are some of the common sites for tendonitis?
Achilles tendon, lateral epicondyle and supraspinatus
How may calcification occur as a result of tendonitis?
Partial tears may heal by forming calcified regions which makes the tendon brittle and it may rupture
What is the treatment for tendonitis?
RICE, stretching, surgery and pain relief
Outline extrinsic and intrinsic tendon healing
Extrinsic - peripheral fibroblasts aid in healing
Intrinsic - fibroblasts from the tendon itself aid in healing
In which tendons does intrinsic tendon healing occur?
Those surrounded by a synovial/tendon sheath e.g. hand flexors
Why may tendon sheaths be affected by rheumatoid arthritis?
As the tendon sheaths have synovial membrane, they can be affected by rheumatoid arthritis
What is the difference between tendonitis and tenosynovitis?
In tenosynovitis there is also inflammation of the tendon sheath lining
What is De Quervain’s tenosynovitis?
There is fibrosis and narrowing of the tendon sheath due to rubbing of the sheath over the radial styloid process
What is trigger finger?
Where there is enlargement of a tendon within the sheath
How do you treat De Quervain’s tenosynovitis?
Shaving the radial styloid process
How do you treat trigger finger?
Cut the annular ligament in the affected finger
What is an enthesis?
Where a tendon/ligament/joint capsule attached to bone
What are the two types of enthesis?
Fibrous and fibrocartilaginous
Describe fibrous entheses
The ligament/tendon joins directly to bone via collagen fibres known as Sharpey’s fibre penetrating the periosteum of the bone
Describe fibrocartilaginous entheses
The tendon/ligament transitions through fibrocartilage regions before reaching the bone, causing the collagen fibres to become more disorganised and mineral content to increase before it reaches the bone
What are Sharpey’s fibres?
The collagen fibres from a tendon/ligament/joint capsule that directly insert into the periosteum of the bone to connect the two structures
What is the advantage of fibrocartilaginous entheses over fibrous entheses?
The gradual change to mineralised content helps to stiffen the ligament and dissipate stress concentration to be more mechanically resistant
What is enthesitis?
Inflammation of the enthesis at any point of attachment inserting into the bone
What is the difference between enthesophytes and osteophytes?
Enthesophytes originate from the insertion of joint capsule/ligament or tendon and don’t involve the articular border to the joint, whereas osteophytes originate from the border of the articular cartilage
What is ankylosing spondylitis?
A form of enthesitis of the intervertebral disc and anterior longitudinal ligament
What may cause enthesitis?
Recurrent stress, autoimmune disease, HLA B27
Which HLA molecule is related to enthesitis?
HLA B27
How may enthesitis be treated?
RICE, NSAIDs, anti-inflammatory drugs and hyperosmolar dextose
Why may hyperosmolar dextrose be used to treat enthesitis?
Injection of this irritant can cause proliferation of the intrinsic fibroblasts to repair the damage
What is systemic lupus erythematosus?
Where the boy makes a wide range of antibodies against self-antigens which cause damage to blood vessels and connective tissue
Who is typically affected by systemic lupus erythematosus?
Females, more likely to be black people and those 15-40
What are the signs/symptoms of systemic lupus erythematosus?
Fever, weight changes, butterfly fascial rash and photosensitivity
How may SLE be treated?
NSAIDs, methotrexate, corticosteroids, cyclophosphamide etc.
