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422, Week 58
Year 2 Laboratory: Histopathology of Synovial Joints
January 17, 2023
Histology Laboratory Guide
Dr. O. Oyedele (olusegun.oyedele@ubc.ca) and Dr. Michael Nimmo (michael.nimmo@vch.ca)
With Dr. Karen Pinder
Learning Objectives:
1. Review the essential histological structure of a typical synovial joint (including cartilage,
absence of perichondrium, synovium, synovial fluid).
2. Relate the histology and ultrastructure of the chondrocyte to its role in the synthesis and
maintenance of the extracellular matrix of cartilage and summarize the essential structural and
functional differences between the three types of cartilage.
3. Review the microscopic organization of tendons, including the ultrastructure and function of
the fibroblast; correlate the structure of the muscle‐tendon junction to force transmission.
4. Describe the pathologic features of common joint conditions including osteoarthritis,
rheumatoid arthritis, and gout.
Slides for study: Histology Pathology
LM #250 – Rat Knee Joint, H&E LMs #p403 Osteoarthritis of the femoral head
LM #p404 Rheumatoid arthritis
LM #10A – Rat Knee Joint, WR
LM #63 – Trachea, H&E LM #p402 Gout
LM #7 – Cartilage Intervertebral Disc, H&E
LM #61 – Epiglottis, Van Gieson (elastin)
LM #10B – Rat Knee Joint, WR
LM #4 – Tendon LS, H&E
Electron
Chondrocyte and ECM (HRSEM)
Micrographs
Chondrocyte in hyaline cartilage of trachea
Nucleus of Fibroblast
Muscle‐tendon junction
References: 1. Netter’s Essential Histology (2nd Ed.), Ovalle & Nahirney: Overview of Cartilage: pp. 132 – 133; Hyaline Cartilage: pp. 134 – 137;
Histology of Synovial Joints: pp. 155 ‐ 156.
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Histopathology of Synovial Joints Jan 17, 2023
Learning Objective #1 – Review the essential histological structure of a typical synovial joint
UBC CPS Virtual Slide #250 – Rat Knee Joint, H&E
The articular surfaces of synovial joints are covered by hyaline cartilage and separated
by a joint cavity filled with synovial fluid. This fluid is secreted in part by synovial
membrane or synovium, which lines all intra‐articular structures except the articular
surfaces. Fibrocartilaginous wedges known as menisci are frequently found as supporting
structures within synovial joints, especially the knee joint. Dense regular connective
tissue encapsulates synovial joints and this joint capsule often serves as insertion points
for tendons. Notice that numerous blood vessels and small nerve bundles are associated with the joint
capsule and synovium (next slide). These structures will be important for the nutrition of the components
of the joint, particularly the articular hyaline cartilage, which is avascular and devoid of innervation. For
this latter reason, degenerative joint diseases progress asymptomatically until more advanced stages of
the disease, when periarticular structures become involved (e.g. due to joint swelling).
UBC CPS Virtual Slide # 10A – Rat Knee Joint, Wright’s Stain
This slide contains all the same histological features of the synovial joint that
were found in Slide #250. It is included for comparison with Slide #250, as well as
for review of the synovial membrane elements of the joint. Once again, find the
synovial membrane in this slide. What are the cells of the synovial membrane
called? Notice that small blood vessels are abundant within the deeper
(subintimal) layer of synovium. Can you remember how these blood vessels
contribute to the formation of most of the synovial fluid? A small component of synovial fluid is not
derived from the blood vessels. How is this component formed?
Learning Objective #2 – Relate histology and ultrastructure of chondrocyte to its function; Summarize
differences between cartilage types.
UBC CPS Virtual Slide # 63 – Trachea, H&E
The cellular elements of both articular and non‐articular hyaline cartilage (an example
of which is found in the trachea) are made up of chondrocytes. Under high
magnification, observe that chondrocytes occupy clear spaces known as lacunae, in
groups of between 2‐6 cells known as isogenous nests. They are secretory cells,
responsible for secreting and maintaining all components of the extracellular matrix
(ECM) within which they lie. Hyaline cartilage ECM contains type II collagen and a
mixture of sulfated and non‐sulfated glycosaminoglycans (GAG).
Observe perichondrium on the outer aspect of the tracheal cartilage. Perichondrium forms a fibrous
connective tissue coat around non‐articular hyaline cartilage. It contains nerves and blood vessels, which
supply the (avascular) hyaline cartilage. By contrast, articular hyaline cartilage is supplied with nutrients
via diffusion from synovial fluid Compare the hyaline cartilage in Slide 63 with that of the articular cartilage
in Slides 250 & 10A).
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Histopathology of Synovial Joints Jan 17, 2023
Ultrastructure of Cartilage
Chondrocyte and ECM (HRSEM)
This scanning electron micrograph (SEM) shows a chondrocyte member of an
isogenous nest. The other chondrocytes in this cluster appear to have been lost,
having popped out during tissue preparation, leaving behind their empty
lacunae. Note the type II collagen fibrils in the surrounding ECM. Other
important constituents of the ECM include proteoglycan macromolecules, whose
interaction with hyaluronic acid, water and the collagen fibril network confers
hyaline cartilage with its resilience. (Used with permission. Copyright © 2013 Elsevier Inc. All rights
reserved. Netter’s Essential Histology, Ovalle & Nahirney, p. 138)
Chondrocyte in hyaline cartilage of trachea
Details of the internal ultrastructural features of chondrocytes is highlighted by this
EM. These features reflect its active secretory function and include a nucleus
composed mostly of euchromatin, cytoplasmic free ribosomes and rough
endoplasmic reticulum, prominent Golgi complex and mitochondria. The
chondrocyte is embedded within the ECM, containing numerous type II collagen
fibrils, which are organized into a loose network.
(Used with permission. Copyright © 2013 Elsevier Inc. All rights reserved. Netter’s Essential Histology,
Ovalle & Nahirney, p. 138)
Structure‐function considerations This schematic highlights the interaction of proteoglycan
aggregates, type II collagen fibrils and chondrocytes
within hyaline cartilage matrix. Each proteoglycan
monomer is rich in chondroitin sulfate and keratin
sulfate molecules. Monomers are bound to the linear
hyaluronan molecules via link proteins to form
proteoglycan aggregates, which are in turn ‘entrapped’
within the web of collagen fibrils by electrostatic
interactions, because they are highly negatively charged.
These intricate interactions, along with the strong
affinity of proteoglycans for water molecules, confer
hyaline cartilage with its characteristic resilience. (See
also Appendix section of lab handout MEDD 421 Week
46 – Histology of the Synovial Joint). Used with permission.
Copyright ©2011 LWW. All Rights Reserved. Histology A Text and Atlas
Ross & Pawlina, p. 200.
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Histopathology of Synovial Joints Jan 17, 2023
UBC CPS Virtual Slide #7 – Cartilage, Intervertebral Disc, H&E
Fibrocartilage is a mixture of dense regular connective tissue (e.g. tendon,
see below) and hyaline cartilage. Hence it is both firm and compressible. It
is found in the annulus fibrosis (outer ring of the core region) of
intervertebral discs and the symphysis pubis, to give a few examples. Parallel
bundles of intensely eosinophilic type I collagen fibers dominate the ECM of
fibrocartilage. (Note that in contrast to hyaline cartilage with type II
collagen, fibrocartilage contains type I collagen). The chondrocytes of
fibrocartilage are scattered throughout the ECM matrix in rows of single
elongated cells surrounded by a small region of basophilic ground substance. Unlike non‐articular hyaline
cartilage, fibrocartilage has no perichondrium.
UBC CPS Virtual Slide #61 ‐ Epiglottis, Van Gieson (elastin) Stain
The distinguishing feature of elastic cartilage is the abundance of elastic fibers
embedded within its ECM, which contains only a small amount of ground substance.
The elastic fibers are arranged in circular networks, or whorls. Chondrocytes, housed
in their lacunae, can be found singly, or in a few isogenous nests. In slide #61, elastic
cartilage forms the core of the epiglottis and confers flexibility to this structure.
Observe the elastic cartilage within the epiglottis and note that elastic fibers are
stained black with this histological preparation, while the surrounding perichondrium
is stained green. Apart from the epiglottis, elastic cartilage may also be found in the
external ear (pinna) and the pharyngotympanic tube. Unlike hyaline cartilage and fibrocartilage, elastic
cartilage does not calcify with age.
Learning Objective #3 – Review the histology and functions of tendon and the muscle‐tendon
junction; correlate the ultrastructure of the fibroblast to its function.
UBC CPS Virtual Slide #4 ‐ Tendon (longitudinal section), H&E
Tendon is the prime example of dense regular connective tissue, made up of parallel
bundles of type I collagen fibers. This arrangement confers strength and durability to
tendons (and fibrocartilage, above) and it explains how tendon can withstand very high
tensile stresses imposed on it during muscle action at muscle‐tendon junctions (below),
as well as at insertion points to bone, ligament or joint capsule. Under high
magnification, observe the flattened nuclei of fibroblasts, arranged in rows between the
stacks of collagen fibers. Fibroblasts secrete and maintain the type I collagen as well as
ground substance of the tendon extracellular matrix.
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Histopathology of Synovial Joints Jan 17, 2023
UBC CPS Virtual Slide #10B ‐ Muscle‐tendon junction, Wright’s stain
Scan Slide #10B to find areas near the synovial joint where skeletal muscle
inserts into tendon (e.g. boxed region in lower right aspect of this image).
Notice that at the muscle tendon junction, the orderly bundles (fascicles) of
striated skeletal muscle change abruptly to dense regular connective tissue.
Under EM observation (below), you will find that in fact, the muscle fibers
interdigitate with similar indentations of tendon connective tissue.
Muscle‐Tendon Junction
This electron micrograph was studied during the Synovial Joint lab in MEDD
421 Week 46. It is included again here for your review. The EM shows details
of the point of insertion of muscle fibers into tendon connective tissue. It is
the point of maximum stress biomechanically during muscle action. In this
micrograph, observe the branching finger‐like projections of myofibrils on the
left as they interlock with corresponding projections of tendon on the right, much like the fingers of two
hands interlocking in a clasp of hands. Collagen fibrils occupy the tendon clefts where they lie in close
contact with the sarcolemma of the myofibrils. (Used with permission. Copyright © 2013 Elsevier Inc. All
rights reserved. Netter’s Essential Histology, Ovalle & Nahirney, p. 85).
Ultrastructure of Fibroblast
Nucleus of Fibroblast
This EM shows two fibroblasts – the upper one dominates the field of view while
the nucleus of the other fibroblast is just visible below. In between the two
fibroblasts, type I collagen fibrils are visible in the ECM. Part of a skeletal muscle
fiber occupies the rest of the micrograph, next to the fibroblasts.
Have a close study of the clearly visible fibroblast to observe the salient
ultrastructural features of an active fibroblast. These features portray its activity
as a ‘workhouse’ for the synthesis of proteins, including collagen and ground substance of the ECM.
Observe its euchromatic nucleus and prominent nucleolus. Zoom in to observe the organelles of the
cytoplasm, including rough endoplasmic reticulum, Golgi complex, mitochondria and numerous
secretory vesicles. (Used with permission. Copyright © 2013 Elsevier Inc. All rights reserved. Netter’s
Essential Histology, Ovalle & Nahirney, p. 56).
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Histopathology of Synovial Joints Jan 17, 2023
Learning Objective #4 – Describe the pathologic features of common joint conditions, including OA, RA
and gout.
Diseases of the joints are common and include degenerative diseases (osteoarthritis) and inflammatory
diseases. Causes of inflammatory joint disease include autoimmune conditions (rheumatoid arthritis),
infection, and crystal deposition (gout).
UBC CPS Virtual Slide #p403, H&E
Osteoarthritis (OA) of the femoral head
Osteoarthritis is a chronic progressive disease of joints characterized by
degeneration of articular cartilage resulting in structural and functional
changes. Slide #p403 shows osteoarthritis of the femoral head. Note how the
articular surface of the hyaline cartilage is no longer smooth (compare it to the
normal surface in Slide #LM‐ 250. The surface of the cartilage is irregular with
fibrillations (projections), fissures and clefts. In areas, there is total loss of the
cartilage with exposure of the underlying cortical bone. This bone becomes
sclerotic (thickened) and subcortical cysts form where the synovial fluid has entered the bone through
cracks in the surface. Finally, spurs of reactive bone begin to grow from the lateral aspects of the joints
creating osteophytes. Osteophytes are not present in this section.
UBC CPS Virtual Slides #p404, H&E
Rheumatoid arthritis (RA)
Rheumatoid arthritis is a chronic systemic autoimmune disease of uncertain etiology characterized by
inflammation of joints and various extraarticular features. Slide #p404 shows the synovium and soft tissue
from a patient with rheumatoid arthritis. There is a chronic inflammatory
cell infiltrate and the synovium is hyperplastic. In addition to the chronic
inflammation this slide also shows a rheumatoid nodule which consists of a
central core of necrotic tissue surrounded by a rim of histiocytes (tissue
macrophages). Not shown here is the mass of edematous synovium,
inflammatory cells, fibroblasts and granulation tissue, known as pannus. In
Rheumatoid arthritis, pannus grows over and erodes the articular cartilage.
With further disease progression, the articular cartilage is lost altogether and only pannus bridges the
articulating bones, leading to fibrous ankylosis, which will eventually become ossified to form bony
ankylosis.
UBC CPS Virtual Slides #p 402, H&E
Gout is a metabolic disease characterized by increased uric acid in the blood
(hyperuricemia) and deposits of uric acid crystals in various organs including
the joints, soft tissue, and kidneys. Deposition of uric acid crystals in the joint
causes an inflammatory reaction and destruction of the joint (see photograph
on page 7). Slide #p402 shows a gouty tophus which is the deposit of uric acid
crystals in soft tissue. The uric acid crystals are surrounded by a rim of
histiocytes. Tophi may occur within the synovium, ligaments, tendons and
other periarticular soft tissues.
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Histopathology of Synovial Joints Jan 17, 2023
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