関: entheses

WordNet

either of two punctuation marks (or) used to enclose textual material
the insertion of a vowel or consonant into a word to make its pronunciation easier; "the insertion of a vowel in the plural of the word `bush is epenthesis"
a notation for forming mathematical expressions that does not use parentheses to delimit components

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/07/27 23:23:22」(JST)

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Enthesis (plural: entheses) is the point at which a tendon or ligament^[1] or muscle^[2] inserts into bone, where the collagen fibers are mineralized and integrated into bone tissue. The collagen to bone interface is via Sharpey's fibers.

Classification[edit]

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[edit]

A disease of the entheses is known as an "enthesopathy" or "enthesitis" and is characteristic of spondyloarthropathy but is present in other pathologies as well.

The enthesis is the primary site of ankylosing spondylitis.

References[edit]

^ iii_1/e/enthesis article at GE's Medcyclopaedia
^ "enthesis" at Dorland's Medical Dictionary

External links[edit]

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.
Origin of phrase at rheuma21st.com at rheuma21st.com

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English Journal

General applications of ultrasound in rheumatology: why we need it in our daily practice.

Ruta S1, Reginato AM, Pineda C, Gutierrez M; Pan-American League Against Rheumatisms (PANLAR) Ultrasound Study Group.
Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases.J Clin Rheumatol.2015 Apr;21(3):133-43. doi: 10.1097/RHU.0000000000000230.
Ultrasound (US) is a noninvasive imaging technique that continues to gain interest among rheumatologists because of its undoubted utility for the assessment of a wide range of abnormalities in rheumatic diseases. It also has a great potential to be used at the time of consultation as an extension of
PMID 25807093

The role of an octacalcium phosphate in the re-formation of infraspinatus tendon insertion.

Itoigawa Y1, Suzuki O2, Sano H3, Anada T4, Handa T5, Hatta T3, Kuwahara Y3, Takahashi A3, Ezoe Y6, Kaneko K7, Itoi E3.
Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.].J Shoulder Elbow Surg.2015 Mar 28. pii: S1058-2746(15)00049-X. doi: 10.1016/j.jse.2015.01.011. [Epub ahead of print]
BACKGROUND: To improve the success rate of rotator cuff repair, we investigated whether octacalcium phosphate (OCP) with gelatin (Gel) vehicle had a positive effect on tendon-to-bone healing.METHODS: We assessed the histologic characteristics of the tendon-to-bone healing using the rabbit rotator cu
PMID 25825137

Ablating hedgehog signaling in tenocytes during development impairs biomechanics and matrix organization of the adult murine patellar tendon enthesis.

Breidenbach AP1, Aschbacher-Smith L, Lu Y, Dyment NA, Liu CF, Liu H, Wylie C, Rao M, Shearn JT, Rowe DW, Kadler KE, Jiang R, Butler DL.
Journal of orthopaedic research : official publication of the Orthopaedic Research Society.J Orthop Res.2015 Mar 25. doi: 10.1002/jor.22899. [Epub ahead of print]
Restoring the native structure of the tendon enthesis, where collagen fibers of the midsubstance are integrated within a fibrocartilaginous structure, is problematic following injury. As current surgical methods fail to restore this region adequately, engineers, biologists and clinicians are working
PMID 25807894

Japanese Journal

アキレス腱付着部障害の治療update (特集腱・靱帯付着部症の最近の展開)

松田剛典,熊井司
整形・災害外科 56(11), 1383-1388, 2013-10
NAID 40019825819

腱・靱帯付着部症の解剖学的要因と病理 (特集腱・靱帯付着部症の最近の展開)

篠原靖司,熊井司
整形・災害外科 56(11), 1337-1334, 2013-10
NAID 40019825626

Technical note: Quantifying size and shape of entheses

HENDERSON C.Y.
Anthropological Science 121(1), 63-73, 2013
… There is variability in enthesis size and distal humeral condyle size; … The use of these parameters for quantifying enthesis size and shape provides insights into enthesis variability which cannot be tested using visual methods alone. …
NAID 130003363104