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J Anat. Feb 1993; 182(Pt 1): 1–11.
PMCID: PMC1259777

Cell and matrix changes associated with pathological calcification of the human rotator cuff tendons.


The causative mechanism of tendon calcification ('calcifying tendinitis') is unknown. In this report, pathological human tendon samples were examined to give morphological and ultrastructural detail of the calcified regions and these findings were compared with those from normal tendon. Selected specimens were cryosectioned to enable histochemical and immunohistochemical comparison of the occurrence and distribution of specific matrix molecules in diseased and normal tendon tissues. The lack of collagen type II and alkaline phosphatase in the pathological regions suggests that the calcification process is not mediated through an endochondral transition. In contrast, the pathological areas were characterised by widespread labelling for chondroitin-4-sulphate/dermatan sulphate and intense pericellular localisation of chondroitin-6-sulphate.

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  • Ayad S, Evans H, Weiss JB, Holt L. Type VI collagen but not type V collagen is present in cartilage. Coll Relat Res. 1984 Mar;4(2):165–168. [PubMed]
  • Benjamin M, Evans EJ, Copp L. The histology of tendon attachments to bone in man. J Anat. 1986 Dec;149:89–100. [PMC free article] [PubMed]
  • Benjamin M, Tyers RN, Ralphs JR. Age-related changes in tendon fibrocartilage. J Anat. 1991 Dec;179:127–136. [PMC free article] [PubMed]
  • Caterson B, Christner JE, Baker JR, Couchman JR. Production and characterization of monoclonal antibodies directed against connective tissue proteoglycans. Fed Proc. 1985 Feb;44(2):386–393. [PubMed]
  • Caterson B, Mahmoodian F, Sorrell JM, Hardingham TE, Bayliss MT, Carney SL, Ratcliffe A, Muir H. Modulation of native chondroitin sulphate structure in tissue development and in disease. J Cell Sci. 1990 Nov;97(Pt 3):411–417. [PubMed]
  • Goret-Nicaise M. Identification of collagen type I and type II in chondroid tissue. Calcif Tissue Int. 1984 Dec;36(6):682–689. [PubMed]
  • Holmdahl R, Rubin K, Klareskog L, Larsson E, Wigzell H. Characterization of the antibody response in mice with type II collagen-induced arthritis, using monoclonal anti-type II collagen antibodies. Arthritis Rheum. 1986 Mar;29(3):400–410. [PubMed]
  • Hunter GK, Allen BL, Grynpas MD, Cheng PT. Inhibition of hydroxyapatite formation in collagen gels by chondroitin sulphate. Biochem J. 1985 Jun 1;228(2):463–469. [PMC free article] [PubMed]
  • Johnson GD, Davidson RS, McNamee KC, Russell G, Goodwin D, Holborow EJ. Fading of immunofluorescence during microscopy: a study of the phenomenon and its remedy. J Immunol Methods. 1982 Dec 17;55(2):231–242. [PubMed]
  • Józsa L, Bálint BJ, Réffy A. Calcifying tendinopathy. Arch Orthop Trauma Surg. 1980;97(4):305–307. [PubMed]
  • Oshima O, Leboy PS, McDonald SA, Tuan RS, Shapiro IM. Developmental expression of genes in chick growth cartilage detected by in situ hybridization. Calcif Tissue Int. 1989 Sep;45(3):182–192. [PubMed]
  • Page M, Ashhurst DE. The effects of mechanical stability on the macromolecules of the connective tissue matrices produced during fracture healing. II. The glycosaminoglycans. Histochem J. 1987 Jan;19(1):39–61. [PubMed]
  • Ralphs JR, Benjamin M, Thornett A. Cell and matrix biology of the suprapatella in the rat: a structural and immunocytochemical study of fibrocartilage in a tendon subject to compression. Anat Rec. 1991 Oct;231(2):167–177. [PubMed]
  • Rathbun JB, Macnab I. The microvascular pattern of the rotator cuff. J Bone Joint Surg Br. 1970 Aug;52(3):540–553. [PubMed]
  • Refior HJ, Krödel A, Melzer C. Examinations of the pathology of the rotator cuff. Arch Orthop Trauma Surg. 1987;106(5):301–308. [PubMed]
  • Sarkar K, Uhthoff HK. Ultrastructural localization of calcium in calcifying tendinitis. Arch Pathol Lab Med. 1978 May;102(5):266–269. [PubMed]
  • Tenenbaum HC, Hunter GK. Chondroitin sulfate inhibits calcification of bone formed in vitro. Bone Miner. 1987 Feb;2(1):43–51. [PubMed]
  • Uhthoff HK. Calcifying tendinitis, an active cell-mediated calcification. Virchows Arch A Pathol Anat Histol. 1975;366(1):51–58. [PubMed]
  • Uhthoff HK, Sarkar K, Maynard JA. Calcifying tendinitis: a new concept of its pathogenesis. Clin Orthop Relat Res. 1976 Jul-Aug;(118):164–168. [PubMed]
  • Uhthoff HK, Sarkar K. Calcifying tendinitis. Baillieres Clin Rheumatol. 1989 Dec;3(3):567–581. [PubMed]
  • von der Mark K, von der Mark H. The role of three genetically distinct collagen types in endochondral ossification and calcification of cartilage. J Bone Joint Surg Br. 1977 Nov;59-B(4):458–464. [PubMed]
  • WATSON ML. Staining of tissue sections for electron microscopy with heavy metals. J Biophys Biochem Cytol. 1958 Jul 25;4(4):475–478. [PMC free article] [PubMed]

Articles from Journal of Anatomy are provided here courtesy of Anatomical Society of Great Britain and Ireland


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