Some Synovio-Entheseal Complex Variants

Synovio-Entheseal Complexes come in many shapes and sizes.

When a patient comes to medical attention with joint pain or swelling anywhere the physician must consider Synovio-Entheseal Complex related disease.

The examples given below show examples of Synovio-Entheseal Complex disease in small and large joints.

It shows examples of Synovio-Entheseal Complex disease in tendons.

Some types of disease including inflammation in small bones within tendons is also linked to Synovio-Entheseal Complex pathology.

Some examples are given below.

This is a an example of a Synovio-Entheseal Cartilage in the knee where a tendon called the Popliteus wraps around articular cartilage (dark blue). Disease of this structure could manifest as knee swelling without the problem in the enthesis that is located inside the joint being detected. This is a very complex Synovio-Entheseal Complex formed on the base of the big toe joint. The big toe and other joints often have a small bone near the enthesis. The lower part of this bone may be lined by fibrocartilages. Diseases of this structure may manifest in a condition called sesamoiditis.
Synvio-Entheseal Complex within the joint capsule in a small finger joint. The capsular Synovio-Entheseal Complex fibrocartilage is called a sesamoid fibrocartilage. It is in close contact with the joint lining or synovium. Disease of this structure will manifest as joint swelling. This is a Synovio-Entheseal Complex within a tendon. Where the tendon wraps around bone such as sites like the ankle both the bone and the undersurface of the tendon are lined by fibrocartilage. The bone lining fibrocartilage is called the periosteal fibrocartilage. In health these shock absorbers protect the tendon from damage. Disease of this structure can manifest of inflammation in the adjacent joint lining in red.


Arthritis Rheum. 2007 Aug;56(8):2482-91.The concept of a "synovio-entheseal complex" and its implications for understanding joint inflammation and damage in psoriatic arthritis and beyond. McGonagle D, Lories RJ, Tan AL, Benjamin M.