The anterior tibio-talar ligament: one reason for anterior ankle impingement.

The purpose of this study was the evaluation of the ankle's anterolateral ligament structures. We documented the anatomic situation of the ankle's anterolateral ligament structures in 33 Thiel-embalmed specimens. The ligaments had been isolated. We performed measurements on both length and orientation and additionally classified the ligaments. We also conducted histologic tissue staining. We were able to document a regular appearance of a so far not well-realized structure between the talus and the tibia, present in 26 (79%) specimens. Average length of this structure was 26 mm (in 20 degrees plantarflexion). The angular orientation in relation to the ant. tibio-fibular lig. was on average 43.7 degrees. This structure could be classified as being either isolated or widespread, with a further four sub-classifications for the orientation. Histologic staining showed parallel orientated dense collagen fibers as well as elastic fibers and hyaline cartilage in different stages of proliferation. In addition, there were neural fibers in the perivascular and the soft tissue. The histologic findings proved that the structure was a ligament. Since the ant. tibio-talar lig. is constantly present in most ankle joints, it could be considered as a regular finding. Its morphology and histology show that this ligament is loaded under tension as well as under compression. This could be one reason for anterior ankle impingement.

Tissue levels of leu-enkephalin in rats with adjuvant arthritis.

To study the level of leu-enkephalin in bone and joint tissues and in the spinal cord of rats with adjuvant arthritis, arthritis was induced in Lewis rats by the injection of Mycobacterium butyricum in Freund's incomplete adjuvant (FIA). Immunoelectron microscopy (IEM) was used to monitor the cellular distribution of leu-enkephalin in control and arthritis groups, and radioimmunoassay (RIA) was used to measure the concentration in the tissues. The results of IEM showed increased levels of leu-enkephalin in the matrix of the sciatic nerve, in nerve fibres in the synovial membrane and periosteum, as well as in fibroblasts and endothelial cells of the periosteum in arthritic groups. In macrophage-like cells of the synovial membrane as well as monocyte and polymorphonuclear lineage cells in the bone marrow, the level of leu-enkephalin was decreased in the arthritic group. The results of RIA showed that the concentration of leu-enkephalin was lower in the ankle and increased in the spinal cord of arthritic animals compared with controls. In conclusion, leu-enkephalin levels were decreased in joints and in bone marrow, but increased in nerve tissues in the group with arthritis. Further studies are needed to show whether leu-enkephalin is involved in a process that serves to limit the effect of immunisation.

Increased levels of somatostatin in rat ankles with adjuvant arthritis.

Levels of somatostatin were investigated in the ankles and spinal cords of rats suffering from acute and chronic adjuvant arthritis. As measured by radioimmunoassay, somatostatin showed significantly higher concentrations only in chronic arthritic ankles. No significant difference was observed in somatostatin levels between the spinal cords of normal and arthritic groups. Using immunohistochemical labeling and electron microscopy, we observed increased somatostatin labeling in the mature bone matrix, monocytes, and polymorphonuclear cells of bone marrow and macrophage-like synovial cells of chronically arthritic rats. Understanding the mechanism(s) which lead to increased somatostatin in chronic arthritic joints may result in more effective treatment methods.

Hyperplastic synoviocytes from rats with streptococcal cell wall-induced arthritis exhibit a transformed phenotype that is thymic-dependent and retinoid inhibitable.

It has been suggested that streptococcal cell wall-induced arthritis in LEW/N rats resembles a localized neoplasm consisting of, in part, a proliferative and invasive population of fibroblast-like synoviocytes. To further pursue this concept, the synoviocytes from diseased rats were characterized in situ and in vitro for various parameters of "transformation." The spindle-shaped synoviocytes were found throughout the synovium and were the predominant cell type at sites of invasion of bone and cartilage by synovium. They stained intensely for vimentin, a microfilament prominently expressed in immature and transformed mesenchymal cells. They stained variably for Ia antigens and did not exhibit T cell surface antigens nor did they stain with histochemical stains characteristic of monocytes or granulocytes. Electron microscopy confirmed their fibroblastlike morphology and suggested high grade metabolic activity. In primary culture, the abnormal synoviocytes were adherent, grew rapidly and did not contact inhibit. Moreover, they grew under anchorage-independent conditions. These abnormal growth characteristics were inhibited by all-trans retinoic acid. Finally, explants of the arthritic synovium formed short-lived tumorlike nodules in athymic nude mice. These observations, considered in the context of other data, support the concept that the pathologic process represents a thymic-dependent, nonmalignant, locally invasive inflammatory neoplasm.