Tendon pathology in long-standing achillodynia - Biopsy findings in 40 patients
Tendon pathology in long-standing achillodynia - Biopsy findings in 40 patients
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DOI：
10.3109/17453679709004002
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发表时间：
1997-04-01
期刊：
影响因子：
--
通讯作者：
Rolf, C
中科院分区：
文献类型：
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作者：
Movin, T;Gad, A;Rolf, C
我们评估了40例长期跟腱痛患者的跟腱活检标本和超声显示的低回声区增宽跟腱。我们采用标准化的方案对HE染色石蜡包埋标本的肌腱一般病理评分进行评估。用阿利新蓝（pH 2.5）染色/周期性酸席夫法（AB/PAS）对富含糖胺聚糖（GAG）区域的体积密度进行立体测量。在尸检中获得的14个标本作为参考材料。所有活检标本均可见纤维结构和排列异常，细胞结构局灶性变化，细胞核圆形，胶原染色降低，非胶原细胞外基质增加。一半的对照组出现了轻微的组织病理学变化。三分之二的患者标本和三分之一的对照标本中存在血管性增加，并且有血管周围出血的迹象，6/40的患者中有铁血黄素沉积，但对照组中没有一例。富gag区体积密度患者为0.47(0 ~ 0.86)，高于对照组（0 ~ 0.07）。纤维结构和排列的改变以及纤维间GAG的增加似乎是长期跟腱痛和超声扩宽的跟腱的特征形态学特征，这些发现可能表明跟腱痛是由于结缔组织代谢或循环的局部紊乱或两者兼而有之。
We evaluated biopsy specimens from the Achilles tendon in 40 patients with long-standing achillodynia and an ultrasonographic widened tendon with hypoechogenic areas. We used a standardized protocol to assess the general tendon pathology score of paraffin-embedded specimens stained with HE. Stereologic measurement of the volume density of glycosaminoglycan (GAG)-rich areas, stained with the Alcian blue (pH 2.5)/periodic acid Schiff method (AB/PAS) was performed. 14 specimens obtained at autopsy served as reference material. Abnormal fiber structure and arrangement, focal variations in cellularity, rounded nuclei, decreased collagen stainability and increased non-collagenous extracellular matrix were seen in all biopsy specimens. Slight histopathological changes were noted in half of the controls. Increased vascularity was present in two thirds of the patient specimens and in one third of the controls, and signs of perivascular hemorrhage, as evidenced by hemosiderin deposition in 6/40 of the patients, but in none of the controls. The volume density of GAG-rich areas was higher in the patients 0.47 (0-0.86) than in the controls 0 (0-0.07).Changes in the fiber structure and arrangement, as well as increased amounts of interfibrillar GAG, appear to be characteristic morphological features in Achilles tendons with long-standing achillodynia and ultrasonographic widening, These findings may indicate that achillodynia is due to local disturbances in connective tissue metabolism or circulation or to both.