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. 2004 Sep;63(9):1015–1021. doi: 10.1136/ard.2003.016378

Figure 4.

Figure 4

 Immunohistochemical labelling of the medial and lateral epicondylar entheses. (A, B) Extensive labelling of fibrocartilage for type II collagen (asterisk) at both the tendon (A) and ligament (B) parts of the lateral epicondylar enthesis. B, bone; DF dense fibrous connective tissue. Scale bars = 500 µm. (C) Strong labelling for type II collagen (arrows) in the region of the medial collateral ligament close to the enthesis, where it wraps around the edge of the humeral articular cartilage. The region illustrated is that indicated by the arrow in fig 1B. Note that only the surface of the ligament is labelled. Scale bar = 100 µm. (D) At the lateral epicondylar enthesis, labelling of the "wrap-around" region of the lateral collateral ligament (that is, where it was in contact with the head of the radius—see arrow in fig 1A) for type II collagen was seen not only at the ligament surface but also in the underlying tissue. Scale bar = 100 µm. (E, F) Aggrecan labelling (asterisk) of fibrocartilage at the ligament (E) and tendon (F) parts of the medial epicondylar enthesis. B, bone. Scale bars = 500 µm. (G, H) Aggrecan labelling (asterisk) of fibrocartilage at the ligament (G) and tendon (H) parts of the lateral epicondylar enthesis. B, bone. Scale bars = 250 µm. (I) Intense labelling for aggrecan at the surface (arrow) of the "wrap-around" region of the lateral collateral ligament (that is, where it was in contact with the head of the radius—see arrow in fig 1A). Scale bar = 50 µm. (J, K) Labelling for link protein (asterisk) in fibrocartilage at both the ligament (J) and tendon (K) parts of the lateral epicondylar enthesis. B, bone. Scale bars = 500 µm. (L) Chondroitin-6-sulphate labelling (asterisk) in fibrocartilage in the tendon part of the medial epicondylar enthesis. B, bone. Scale bar = 100 µm. (M) Chondroitin-6-sulphate labelling (asterisk) in fibrocartilage in the ligament part of the lateral epicondylar enthesis. B, bone. Scale bar = 100 µm. (N) Strong labelling for chondroitin-6-sulphate (arrow) in the region of the lateral collateral ligament close to the enthesis, where it wraps around the head of the radius. The region illustrated is that indicated by the arrow in fig 1A. Scale bar = 50 µm. (O) Type I collagen labelling in the ligament part of the lateral epicondylar enthesis. Note the strong labelling of both the dense fibrous zone of the ligament enthesis (DF) and the bone (B), but the absence of labelling from the calcified (CF) and much of the uncalcified enthesis fibrocartilage (UF). The dotted line indicates the position of the tidemark. Scale bar = 500 µm. (P) Versican labelling in the ligament part of the lateral epicondylar enthesis. Labelling is present in the dense fibrous zone (DF), part of the adjacent zone of uncalcified fibrocartilage (UF), and the zone of calcified fibrocartilage (CF). However, labelling was largely absent from the deeper part of the zone of uncalcified fibrocartilage (asterisk). B, bone. Scale bar = 250 µm. (Q) Low power view of type II collagen labelling (asterisk) of fibrocartilage at the surface of a small bony spur (BS) in the tendon (T) part of the lateral epicondylar enthesis. Scale bar = 500 µm. (R) High power view of the region enclosed in the rectangle in (Q) showing a small venule (V) packed with blood cells, passing between tendon and bone in the type II collagen positive region (asterisk). Scale bar = 250 µm. (S) Strong labelling for link protein (asterisk) around the tip of the bony spur (BS) featured in (Q) and (R) and in the uncalcified fibrocartilage (UF) of the tendon. A similar labelling pattern was also evident for aggrecan. Scale bar = 500 µm.