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Figure 3 Microanatomical changes in enthesitis

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1 Figure 3 Microanatomical changes in enthesitis
Figure 3 | Microanatomical changes in enthesitis. In a normal enthesis, a tendon inserts into a porous trabecularized bone, which is characterized by a high number of transcortical microvessels (TCVs) that enable communication between the bone marrow and the enthesis. The bone–entheseal junction is subject to mechanical stress (red star). Following mechanical stress at the enthesis, TCVs are activated and an inflammatory reaction (osteitis) forms in the adjacent bone marrow. TCV widening via vasodilatation facilitates the efflux of immune cells (such as neutrophils) from the perientheseal bone marrow into the enthesis. Schett, G. et al. (2017) Enthesitis: from pathophysiology to treatment Nat. Rev. Rheumatol. doi: /nrrheum


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