Connective tissue articular cartilage

The salicylates and nonsteroidal anti-inflammatory drug (NSAIDs) are important in the treatment of arthritic conditions. For example, the salicylates and NSAIDs are used in the treatment of rheumatoid arthritis (a chronic disease characterized by inflammatory changes within the body s connective tissue) and osteoarthritis (a noninflammatory joint disease resulting in degeneration of the articular cartilage and... 

RA is a chronic systemic disease that produces inflammatory changes throughout the connective tissue in the body. It affects joints and other organ systems of the body. Destruction of articular cartilage occurs, affecting joint structure and mobility. RA primarily affects individuals between 20 and 40 years of age. 

Gout. An inherited metabolic disorder occurring especially in men, characterized by a raised but variable blood uric acid level, recurrent acute arthritis of sudden onset, deposition of crystalline sodium urate in connective tissues and articular cartilage, and progressive chronic arthritis. 

Aydelotte, M. B. and Kuettner, K. E. (1988) Differences between sub-populations of cultured bovine articular chondrocytes. I. Morphology and cartilage matrix production. Connect. Tissue Res. 18, 205-22. 

Eisenberg, S.R. and Grodzinsky, A.J. (1985) Swelling of articular cartilage and other connective tissues electromechanical forces. Journal of Orthopaedic Research 3, 148-159... 

A. Maroudas, G. Palla, and E. Gilav, Racemization of aspartic acid in human articular cartilage, Connect. Tissue Res., 1992,28, 161-169. 

Before we consider how ROIs may compromise connective tissue structure and function during inflammation, let us briefly turn our attention to the fundamental structure of connective tissues. In order to illustrate the major considerations regarding the structure of connective tissues, I have specifically chosen one example, articular cartilage. 

Composition and organization of connective tissues (with special reference to articular cartilage)... 

Fig. 1. Schematic illustration of the major components of articular cartilage connective tissue, showing some of the known targets (asterisks) of ROI-mediated damage (cleavage, fragmentation, cross-...

The evidence for a pathophysiological role of oxidants in connective tissue injury is not confined to oxidative damage to the component macromolecules. Since there is reasonable indirect evidence that ROIs are released into the articular joint space during inflammation, it is likely that ROIs released from inflammatory cells which are adherent to or in contact with the articular cartilage surface might also damage the cellular components of articular cartilage. 

Gastpar, H. Biology of the articular cartilage in health and disease. Proc. Second Munich Symposium on Biology of Connective Tissue, Munich, July 23-24,1979 F.K. Schattauer Verlag, Stuttgart, 1980. 

Fig. 4.4 Coronal histological section of the lateral margin of ACL tibial footprint (original magnification x 1). The lateral meniscus attaches to the base of lateral groove and the lateral aspect of the protrusion with connective tissue. AC articular cartilage of lateral tibial plateau. White dot area connective tissue (CT) of anterior horn of lateral meniscus. Black dash line bony protrusion of ACL tibial footprint. Arrowhead base of lateral groove...

As with neuraxial injections, the concept of articular injection is to provide a high concentration of drug proximal to the location of the suspected origin of pain. Although intra-articular deposition certainly will produce a high concentration inside the joint, there is still a debate as to whether this is the major relevant site for pain treatment, as much of articular pain is believed to be mediated from structures outside the joint cavity, such as tendons, connective tissue, capsules, and muscle. Also, there is a concern that high concentration of intra-articular corticosteroid may have deleterious effects on cartilage and bone, as reported in some rare cases. 

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