Tendon structure, disease, and imaging

Abstract

Tendon imaging plays a critical role in evaluating tendon diseases and injuries including mechanical, degenerative, and overuse disease, inflammatory enthesitis, as well as partial and full thickness tears. Ultrasound and magnetic resonance imaging (MRI), each with unique benefits and limitations, are commonly utilized to assist in diagnosing these diseases and conditions. This review delineates important structural properties of tendon and biochemical changes occurring in tendon pathology. This review also examines commonly injured tendons including tendons of the elbow, tendons of the rotator cuff of the shoulder, hip abductor tendons, patellar tendons, and the Achilles tendon to help clinicians better recognize tendon disease. Finally, this paper introduces several emerging imaging techniques including T2 mapping, ultra-short echo time MRI, and sonoelastography as ways in which tendon imaging and evaluation may be improved.

Assessment of different fitting methods for in-vivo bi-component T2* analysis of human patellar tendon in magnetic resonance imaging

“…Various imaging methods including ultrasound and conventional MR imaging have been used to evaluate tendon 36 . However, tendon and other musculoskeletal tissues containing abundant highly organized col- Assessment of different fitting methods for in vivo bi-component T2* analysis of human patellar tendon in magnetic resonance imaging 25,39 and zero echo-time (ZTE) imaging 40,41 have been recently developed to capture the rapidly decaying signal within musculoskeletal tissues.…”

Imaging of the rabbit supraspinatus enthesis at 7 Tesla: a 4‐week time course after repair surgery and effect of channeling

“…We characterized the SSP enthesis reformation of a rabbit rotator cuff tear in the first 4 weeks after surgical anchor repair using quantitative high‐resolution T2 mapping at 7T. The transversal relaxation time in the tendon tissue depends on the collagen content, the collagen fiber orientation, as well as the content of free water . The SSP tendon consists largely of type I collagen fibers with a triple helical molecular structure and high supramolecular organization, optimized for transmitting forces generated by the SSP muscle to the bone .…”

“…The transversal relaxation time in the tendon tissue depends on the collagen content, the collagen fiber orientation, as well as the content of free water. 23,29 The SSP tendon consists largely of type I collagen fibers with a triple helical molecular structure and high supramolecular organization, optimized for transmitting forces generated by the SSP muscle to the bone. 9,30 In the current study, T2 relaxation times represented an average of voxel T2 captured from tendon and fibrocartilage zones of the enthesis.…”

Assessment of enthesitis in patients with psoriatic arthritis using clinical examination and ultrasound

“…The poor association between PD and enthesitis scores in our study might be explained by the fact that there are fewer vessels in inflamed enthesis compared with synovium making it harder to visualize 22,23 . US examinations was assessed in positions previously described 12 but not fully relaxed positions, and this may also contribute to reduction of the sensitivity of PD [24][25][26][27] . Previous studies by Gutierrez et al 28 , Koenig et al 29 and Zappia et al 30 revealed changes in intratendinous PD related to joint position.…”