CHAPTER 4
Connective Tissue
71
CLINICAL CORRELATION
Figure 4-15C.
Tendinosis.
Tendinosis
is a
degenerative
disease that occurs
within the substance of a tendon. This condition is
usually associated with age, overexertion, or both.
Histologic examination reveals abnormal F
brotic
structure including
collagen
disorganization
,
decreased f
ber diameter
, and
increased mucoid
ground substance
. Additional F
ndings are
collagen
microtears
,
±ocal hypercellularity
,
vascular proli±-
eration
, and
±ocal necrosis
with
calcif
cation
. Tear-
ing of the tendon can occur in severe cases. Treat-
ment includes pain relief, rest, physical therapy,
nonsteroidal anti-
infl
ammatory drugs, corticoster-
oids, and surgical repair, when necessary. The goal
is to prevent further degeneration and to preserve
function.
D. Cui
C
Collagen microtear
Increased mucoid
ground substance
Calcification
Proliferated
blood vessel
Excess fibroblasts
Figure 4-15A.
Dense regular connective tissue,
tendon.
H&E,
3
289; inset
3
410
This type of tissue is composed of coarse collagen
bundles that is densely packed and oriented into
parallel
cylinders. Long, thin
f broblasts
are found
among the F ber bundles and are oriented in the
same direction as the F
bers. The nuclei of the F
bro-
blasts are visible, but the cytoplasm is not easily
seen. The thick bundles of
collagen f
bers
F ll the
intercellular spaces.
Dense regular connective tis-
sue
provides resistance to traction forces in ten-
dons and
ligaments.
Fibroblasts
Fibroblasts
Collagen
Collagen
fibers
fibers
Collagen
Collagen
fibers
fibers
Fibroblasts
Fibroblasts
Collagen
fibers
Fibroblasts
Fibroblasts
Collagen
fibers
A
D. Cui
B
Collagen fiber
Ground substance
Fibroblast
Figure 4-15B.
A representation o± dense
regular
connective tissue.
Collagen f
bers
are represented by uniformly
arranged thick, pink bundles that are tightly packed
in a parallel fashion.
Fibroblasts
are seen among
these F
bers. The white background represents the
ground substance
. This tissue architecture can be
found in tendons, ligaments, and
aponeuroses.
The structure formed by this arrangement is par-
ticularly strong and resistant to stress such as the
intense forces exerted on ligaments and tendons by
athletes.
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