Microdamage and altered vascularity at the enthesis-bone interface provides an anatomic explanation for bone involvement in the HLA-B27- associated spondylarthritides and allied disorders

Abstract

Ligaments and tendons attach to the skeleton at entheses and inflamed entheses are generally attributed to soft tissue and its insertion. This study investigated the microanatomy and histopathology of bone at entheses and showed that the trabecular network beneath the bone’s cortical shell is an integral part of the enthesis. Significant levels of microdamage and tissue repair were seen at the interface of soft tissue and bone and findings have implications for the aetiology of conditions such as SAHPO syndrome and spondylarthritis. Toumi performed the histology, data collection and analysis, designed the treatment and contributed to writing the manuscript.