I think my free bisphosphonate would be .. good .. here ..
http://tinyurl.com/ypps44

They ARE using bisphosphonates for these "changes in the entheses" ..

"one their most striking findings was the evidence of changes in the
entheses"

http://tinyurl.com/ytz2t8

New insights into inflammation in osteoarthritis
The most common degenerative joint disease, osteoarthritis (OA) is
marked by the breakdown of articular cartilage, which is the type of
cartilage that lines the ends of most limb bones. It can afflict any
jointfingers, toes, wrists, ankles, elbows, shoulders, and the spine,
as well as the weight-bearing knees and hips. As OA progresses,
sufferers often experience inflammation around the affected joint.
This inflammation has been attributed to bits of cartilage breaking
off and aggravating the synovium, the thin, smooth membrane lining a
joint. Yet, MRI detection of prominent synovitis in early OAwhen joint
cartilage appears normalsuggests that other joint structures may be
involved in triggering this inflammation. Recent studies of
inflammation in spinal arthritis implicate the enthesis, which is the
attachment site of ligament or tendon to bone as being a potential
driving factor in joint inflammation.

Intrigued by the potential role of tendon or ligament attachment sites
in synovitis, Professors Michael Benjamin of Cardiff University and
Dennis McGonagle of the University of Leeds decided to investigate the
extent to which different entheses could contribute to inflammation by
forming a functional unit and destructive partnership with adjacent
synovium. Featured in the November 2007 issue of Arthritis &
Rheumatism (http://www.interscience.wiley.com/journal/arthritis),
their findings shed light on a potential novel mechanism for synovial
inflammation in degenerative arthritis. This is based on a structure
that the authors have called the synovial-entheseal complex (SEC).
Basically insertions have a different type of cartilage called
fibrocartilage near the bone. Although this is different from
articular cartilage that lines the ends of bones, the authors
speculated that this type of cartilage could also derive nourishment
from synovium. However, this close integration although desirable in
health could have unfortunate consequences if the enthesis was
damaged.

To validate the widespread formation and to explore further, the
possible inflammatory function of SECs, researchers collected ligament
and tendon attachment samples from 60 cadavers, 35 male and 25 female,
with a mean age of 84 years at death. 49 different entheses19 from the
arms, 26 from the legs, and 4 from the spinal columnwere preserved for
examination. To exclude cartilage degeneration as a trigger for
synovial inflammation, 17 of the selected entheses were not
immediately adjacent to joint cartilage. Each sample was studied for
evidence of inflammatory cells and soft tissue microdamage, as well as
for the composition of SECs.

At 82 percent of the entheses, the formation of a SEC was found. As
expected, this occurred in entheses very close to joint cartilage,
where the synovium was often part of the joint itself. However, a SEC
was also detected in 47 percent of the sites separated from joint
cartilage. For example, the SEC found at the Achilles tendon was
formed with synovium that protruded from a cavity called a bursa,
located a considerable distance from the ankle joint.

Joint insertions are sites of high mechanical stressing and the
authors speculated that this could lead to damage within them,
including their fibrocartilage This is exactly what the authors found.
Degenerative changesat least one and sometimes severalwere detected on
the soft tissue side of attachment sites. Most notably, cell
clustering and/or fissuring was found in 76 percent of entheses. In 85
percent of SECs, the synovial component also showed evidence of mild
inflammatory change. Finally, in 73 percent of the attachments, small
numbers of inflammatory cells were present in the enthesis itself.
Therefore the authors suggest that joint degeneration of
fibrocartilage at insertions could trigger inflammation within SECs.

As Professors Benjaminand McGonagle note, one their most striking
findings was the large number of attachment sites with evidence of
changes in the entheses mirroring those typically seen in joint
cartilage in OAfibrocartilage cell clusters, cell hypertrophy, and
fissuring among them. Such changes at certain entheses could be
directly relevant to older subjects with joint symptoms due to
degenerative disease, Professor McGonagle observes, and some of the
symptoms could be emanating from the SEC.

Affirming the concept of a synovio-etheseal complex as widely
applicable at many sites in the body, both right next to and removed
from joint cartilage, this study also supports the idea that
biomechanical factors related to the enthesis could play an important
role in synovial inflammation in both degenerative and inflammatory
arthritis.

Contact: Amy Molnar
amolnar@wiley.com
John Wiley & Sons, Inc.
Source:Eurekalert

----------------------------------------

Bisphosphonates reduce bone mineral loss at ligament entheses after
joint injury.
Osteoarthritis and Cartilage, Volume 13, Issue 9, Pages 790-797
M. Doschak, J. LaMothe, D. Cooper, B. Hallgrimsson, D. Hanley, R.
Bray, R. Zernicke

http://www.thefinalsprint.com/tag/stress-fracture/

Who loves ya.
Tom

Jesus Was A Vegetarian!
http://jesuswasavegetarian.7h.com

Man Is A Herbivore!
http://tinyurl.com/a3cc3

DEAD PEOPLE WALKING
http://tinyurl.com/zk9fk