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The term ‘tendinopathy’ describes a spectrum of disorders of tendon structure and physiology that result in significant pain and dysfunction in human beings of all ages and activity levels. Disorders include inflammatory conditions of the connective tissue (paratendinitis) or synovial tendon sheath (tenosynovitis), pathologies at the enthesis (insertion), or pathologies of the core tendon itself. The pathological findings in core midsubstance tendon pathologies are termed tendinosis. This is a variable condition but on the whole consists of fibre disruption and disorganisation,1 extracellular matrix changes,2 cell death,3 and the development of painful new vessels and accompanying sensory nerves, and in some cases hyper-cellularity of fibroblasts and formation of adhesions.4 ,5 Fibroblast differentiation may in some cases lead to metaplasia with the formation of adipose tissue, bone and cartilage. These changes vary across patients, and tendons may differ in their response to injury, but on the whole they can be described as partly degenerative and partly disordered repair.
Role of inflammation unclear
The role of inflammation …
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