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<title>Enthesis</title>

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<span id="openzim-page-title" class="mw-page-title-main"><span class="mw-page-title-main">Enthesis</span></span>

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</style><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above" style="background-color:dimgray; color: white">Enthesis</th></tr><tr><td colspan="2" class="infobox-image"><div class="infobox-caption">Typical joint</div></td></tr><tr><th colspan="2" class="infobox-header" style="background-color: #efefef">Identifiers</th></tr><tr><th scope="row" class="infobox-label" style="padding-right:0.25em"><a href="Terminologia_Histologica" title="Terminologia Histologica">TH</a></th><td class="infobox-data"><a rel="nofollow" class="external text" href="https://ifaa.unifr.ch/Public/EntryPage/PDF/TH%20Chapter%20H3.03.pdf">H3.03.00.0.00034 </a></td></tr><tr><td colspan="2" class="infobox-below"><a href="Anatomical_terminology" title="Anatomical terminology">Anatomical terminology</a><div style="text-align: right;"></div></td></tr></tbody></table>

<p>The <b>enthesis</b> (plural <b>entheses</b>) is the <a href="Connective_tissue" title="Connective tissue">connective tissue</a> which attaches <a href="Tendon" title="Tendon">tendons</a> or <a href="Ligament" title="Ligament">ligaments</a> to a <a href="Bone" title="Bone">bone</a>.<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup>

</p><p>There are two types of entheses: <i><a href="Fibrous_tissue" class="mw-redirect" title="Fibrous tissue">fibrous</a> entheses</i> and <i><a href="Fibrocartilaginous" class="mw-redirect" title="Fibrocartilaginous">fibrocartilaginous</a> entheses</i>.<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup>

</p><p>In a fibrous enthesis, the collagenous tendon or ligament directly attaches to the bone.

</p><p>In a fibrocartilaginous enthesis, the interface presents a gradient that crosses four transition zones:<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup>

</p>

<ol><li>Tendinous area displaying longitudinally oriented <a href="Fibroblast" title="Fibroblast">fibroblasts</a> and a parallel arrangement of <a href="Collagen_fibre" class="mw-redirect" title="Collagen fibre">collagen fibres</a></li>

<li>Fibrocartilaginous region of variable thickness where the structure of the cells changes to <a href="Chondrocyte" title="Chondrocyte">chondrocytes</a></li>

<li>Abrupt transition from cartilaginous to <a href="Calcified" class="mw-redirect" title="Calcified">calcified</a> fibrocartilage—often called 'tidemark' or 'blue line'</li>

<div class="mw-heading mw-heading2"><h2 id="Clinical_significance">Clinical significance</h2></div>

<p>A disease of the entheses is known as an <i><a href="Enthesopathy" title="Enthesopathy">enthesopathy</a></i> or <i><a href="Enthesitis" title="Enthesitis">enthesitis</a></i>.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup>

</p><p>Enthetic degeneration is characteristic of <a href="Spondyloarthropathy" class="mw-redirect" title="Spondyloarthropathy">spondyloarthropathy</a> and other pathologies.

</p><p>The enthesis is the primary site of disease in <a href="Ankylosing_spondylitis" title="Ankylosing spondylitis">ankylosing spondylitis</a>.

</p>

<div class="mw-heading mw-heading2"><h2 id="Society_and_culture">Society and culture</h2></div>

<div class="mw-heading mw-heading3"><h3 id="Bioarchaeology">Bioarchaeology</h3></div>

<p>Entheses are widely recorded in the field of <a href="Bioarchaeology" title="Bioarchaeology">bioarchaeology</a>, in which the presence of anomalies at these sites, called <a href="Bioarchaeology#Mechanical_stress_and_activity_indicators" title="Bioarchaeology">entheseal changes</a>, has been used to infer repetitive loading to study the division of labour in past populations.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Several different recording methods have been proposed to record the variety of changes seen at these sites.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:0_8-0" class="reference"><a href="#cite_note-:0-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:2_15-0" class="reference"><a href="#cite_note-:2-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:1_16-0" class="reference"><a href="#cite_note-:1-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> Previous studies have shown that, whichever recording method is used, certain entheseal changes occur more frequently in older individuals.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:0_8-1" class="reference"><a href="#cite_note-:0-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> Moreover, research demonstrates that diseases, such as <a href="Ankylosing_spondylitis" title="Ankylosing spondylitis">ankylosing spondylitis</a> and <a href="Calcific_tendinitis" title="Calcific tendinitis">calcific tendinitis</a>,<sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> also have to be taken into consideration. Nevertheless, experimental studies relying on virtual anthropological methods of analysis (e.g.,"Validated Entheses-based Reconstruction of Activity" 1.0 and 2.0 <sup id="cite_ref-:2_15-1" class="reference"><a href="#cite_note-:2-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:1_16-1" class="reference"><a href="#cite_note-:1-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-23" class="reference"><a href="#cite_note-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup>) have demonstrated how loading history (physical activity) can increase the relative three-dimensional (3D) size of muscle attachment sites <sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> and their subtle surface changes. <sup id="cite_ref-:1_16-2" class="reference"><a href="#cite_note-:1-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup>

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<div class="mw-heading mw-heading2"><h2 id="History">History</h2></div>

<p>"Enthesis" is rooted in the <a href="Ancient_Greek" title="Ancient Greek">Ancient Greek</a> word, "ἔνθεσις" or "énthesis," meaning “putting in," or "insertion." This refers to the role of the enthesis as the site of attachment of bones with tendons or ligaments. Relatedly, in <a href="Anatomical_terms_of_muscle" title="Anatomical terms of muscle">muscle terminology</a>, the <a href="Anatomical_terms_of_muscle#Insertion_and_origin" title="Anatomical terms of muscle">insertion</a> is the site of attachment at the end with predominant movement or action (opposite of the origin). Thus the words (<i>enthesis</i> and <i>insertion</i> [of muscle]) are proximal in the <a href="Semantic_field" title="Semantic field">semantic field</a>, but <i>insertion</i> in reference to muscle can refer to any relevant aspect of the site (i.e., the attachment per se, the bone, the tendon, or the entire area), whereas <i>enthesis</i> refers to the attachment per se and to ligamentous attachments as well as tendinous ones.

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<ul><li><a href="Sharpey's_fibres" title="Sharpey's fibres">Sharpey's fibres</a></li></ul>

<div class="mw-heading mw-heading2"><h2 id="References">References</h2></div>

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<li id="cite_note-10"><span class="mw-cite-backlink"><b><a href="#cite_ref-10">^</a></b></span> <span class="reference-text"><cite id="CITEREFMariottiFacchiniBelcastro2004" class="citation journal cs1">Mariotti V, Facchini F, Belcastro MG (June 2004). <a rel="nofollow" class="external text" href="http://hrcak.srce.hr/index.php?id_clanak=4894&show=clanak">"Enthesopathies--proposal of a standardized scoring method and applications"</a>. <i>Collegium Antropologicum</i>. <b>28</b> (1): <span class="nowrap">145–</span>159. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15636072">15636072</a>.</cite></span>

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<li id="cite_note-11"><span class="mw-cite-backlink"><b><a href="#cite_ref-11">^</a></b></span> <span class="reference-text"><cite id="CITEREFMariottiFacchiniGiovanna_Belcastro2007" class="citation journal cs1">Mariotti V, Facchini F, Giovanna Belcastro M (March 2007). <a rel="nofollow" class="external text" href="http://hrcak.srce.hr/index.php?show=clanak&id_clanak_jezik=43175">"The study of entheses: proposal of a standardised scoring method for twenty-three entheses of the postcranial skeleton"</a>. <i>Collegium Antropologicum</i>. <b>31</b> (1): <span class="nowrap">291–</span>313. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/17598416">17598416</a>.</cite></span>

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<li id="cite_note-12"><span class="mw-cite-backlink"><b><a href="#cite_ref-12">^</a></b></span> <span class="reference-text"><cite id="CITEREFVillotte" class="citation web cs1">Villotte S. <a rel="nofollow" class="external text" href="https://www.academia.edu/1427191">"Practical protocol for scoring the appearance of some fibrocartilaginous entheses on the human skeleton"</a>.</cite></span>

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<li id="cite_note-13"><span class="mw-cite-backlink"><b><a href="#cite_ref-13">^</a></b></span> <span class="reference-text"><cite id="CITEREFVillotteCastexCouallierDutour2010" class="citation journal cs1">Villotte S, Castex D, Couallier V, Dutour O, Knüsel CJ, Henry-Gambier D (June 2010). "Enthesopathies as occupational stress markers: evidence from the upper limb". <i>American Journal of Physical Anthropology</i>. <b>142</b> (2): <span class="nowrap">224–</span>234. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2Fajpa.21217">10.1002/ajpa.21217</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20034011">20034011</a>.</cite></span>

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<li id="cite_note-14"><span class="mw-cite-backlink"><b><a href="#cite_ref-14">^</a></b></span> <span class="reference-text"><cite id="CITEREFVillotteAssisCardosoHenderson2016" class="citation journal cs1">Villotte S, Assis S, Cardoso FA, Henderson CY, Mariotti V, Milella M, et al. (June 2016). <a rel="nofollow" class="external text" href="https://hal.archives-ouvertes.fr/hal-02266502/file/Villotte%20et%20al.%20Termino%20auteur.pdf">"In search of consensus: Terminology for entheseal changes (EC)"</a> <span class="cs1-format">(PDF)</span>. <i>International Journal of Paleopathology</i>. <b>13</b>: <span class="nowrap">49–</span>55. <a href="Bibcode_(identifier)" class="mw-redirect" title="Bibcode (identifier)">Bibcode</a>:<a rel="nofollow" class="external text" href="https://ui.adsabs.harvard.edu/abs/2016IJPal..13...49V">2016IJPal..13...49V</a>. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.ijpp.2016.01.003">10.1016/j.ijpp.2016.01.003</a>. <a href="Hdl_(identifier)" class="mw-redirect" title="Hdl (identifier)">hdl</a>:<a rel="nofollow" class="external text" href="https://hdl.handle.net/10316%2F44443">10316/44443</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29539508">29539508</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:3902457">3902457</a>.</cite></span>

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<li id="cite_note-:2-15"><span class="mw-cite-backlink">^ <a href="#cite_ref-:2_15-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:2_15-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><cite id="CITEREFKarakostisLorenzo2016" class="citation journal cs1">Karakostis, Fotios Alexandros; Lorenzo, Carlos (2016). <span class="id-lock-subscription" title="Paid subscription required"><a rel="nofollow" class="external text" href="https://onlinelibrary.wiley.com/doi/10.1002/ajpa.22999">"Morphometric patterns among the 3D surface areas of human hand entheses"</a></span>. <i>American Journal of Biological Anthropology</i>. <b>160</b> (4): <span class="nowrap">694–</span>707. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2Fajpa.22999">10.1002/ajpa.22999</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/27166777">27166777</a>.</cite></span>

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<li id="cite_note-:1-16"><span class="mw-cite-backlink">^ <a href="#cite_ref-:1_16-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:1_16-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-:1_16-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text"><cite id="CITEREFKarakostis2025" class="citation journal cs1">Karakostis, Fotios Alexandros (2025-04-16). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002543">"Introducing "Validated entheses-Based reconstruction of activity 2.0" (VERA 2.0): Semi-automated 3D analysis of bone surface changes"</a>. <i>PLOS ONE</i>. <b>20</b> (4): e0321479. <a href="Bibcode_(identifier)" class="mw-redirect" title="Bibcode (identifier)">Bibcode</a>:<a rel="nofollow" class="external text" href="https://ui.adsabs.harvard.edu/abs/2025PLoSO..2021479K">2025PLoSO..2021479K</a>. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1371%2Fjournal.pone.0321479">10.1371/journal.pone.0321479</a></span>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1932-6203">1932-6203</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002543">12002543</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/40238840">40238840</a>.</cite></span>

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<li id="cite_note-17"><span class="mw-cite-backlink"><b><a href="#cite_ref-17">^</a></b></span> <span class="reference-text"><cite id="CITEREFKarakostisHotzScherfWahl2018" class="citation journal cs1">Karakostis, Fotios Alexandros; Hotz, Gerhard; Scherf, Heike; Wahl, Joachim; Harvati, Katerina (May 2018). <span class="id-lock-subscription" title="Paid subscription required"><a rel="nofollow" class="external text" href="https://onlinelibrary.wiley.com/doi/10.1002/ajpa.23421">"A repeatable geometric morphometric approach to the analysis of hand entheseal three-dimensional form"</a></span>. <i>American Journal of Physical Anthropology</i>. <b>166</b> (1): <span class="nowrap">246–</span>260. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2Fajpa.23421">10.1002/ajpa.23421</a>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0002-9483">0002-9483</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29399778">29399778</a>.</cite></span>

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<li id="cite_note-18"><span class="mw-cite-backlink"><b><a href="#cite_ref-18">^</a></b></span> <span class="reference-text"><cite id="CITEREFCardosoHenderson2013" class="citation journal cs1">Cardoso FA, Henderson C (2013-03-01). "The Categorisation of Occupation in Identified Skeletal Collections: A Source of Bias?". <i>International Journal of Osteoarchaeology</i>. <b>23</b> (2): <span class="nowrap">186–</span>196. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2Foa.2285">10.1002/oa.2285</a>. <a href="Hdl_(identifier)" class="mw-redirect" title="Hdl (identifier)">hdl</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://hdl.handle.net/10316%2F21142">10316/21142</a></span>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1099-1212">1099-1212</a>.</cite></span>

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<li id="cite_note-19"><span class="mw-cite-backlink"><b><a href="#cite_ref-19">^</a></b></span> <span class="reference-text"><cite id="CITEREFMichopoulouNikitaValakos2015" class="citation journal cs1">Michopoulou E, Nikita E, Valakos ED (December 2015). <a rel="nofollow" class="external text" href="https://doi.org/10.1002%2Fajpa.22822">"Evaluating the efficiency of different recording protocols for entheseal changes in regards to expressing activity patterns using archival data and cross-sectional geometric properties"</a>. <i>American Journal of Physical Anthropology</i>. <b>158</b> (4): <span class="nowrap">557–</span>568. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1002%2Fajpa.22822">10.1002/ajpa.22822</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26239396">26239396</a>.</cite></span>

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<li id="cite_note-20"><span class="mw-cite-backlink"><b><a href="#cite_ref-20">^</a></b></span> <span class="reference-text"><cite id="CITEREFMilellaGiovanna_BelcastroZollikoferMariotti2012" class="citation journal cs1">Milella M, Giovanna Belcastro M, Zollikofer CP, Mariotti V (July 2012). "The effect of age, sex, and physical activity on entheseal morphology in a contemporary Italian skeletal collection". <i>American Journal of Physical Anthropology</i>. <b>148</b> (3): <span class="nowrap">379–</span>388. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2Fajpa.22060">10.1002/ajpa.22060</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/22460619">22460619</a>.</cite></span>

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<li id="cite_note-21"><span class="mw-cite-backlink"><b><a href="#cite_ref-21">^</a></b></span> <span class="reference-text"><cite id="CITEREFHendersonMariottiSantosVillotte2017" class="citation journal cs1">Henderson CY, Mariotti V, Santos F, Villotte S, Wilczak CA (2017-06-20). "The new Coimbra method for recording entheseal changes and the effect of age-at-death". <i>BMSAP</i>. <b>29</b> (<span class="nowrap">3–</span>4): <span class="nowrap">140–</span>149. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2Fs13219-017-0185-x">10.1007/s13219-017-0185-x</a>. <a href="Hdl_(identifier)" class="mw-redirect" title="Hdl (identifier)">hdl</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://hdl.handle.net/10316%2F44430">10316/44430</a></span>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0037-8984">0037-8984</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:29420179">29420179</a>.</cite></span>

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<li id="cite_note-22"><span class="mw-cite-backlink"><b><a href="#cite_ref-22">^</a></b></span> <span class="reference-text"><cite id="CITEREFHenderson2013" class="citation journal cs1">Henderson CY (March 2013). "Do diseases cause entheseal changes at fibrous entheses?". <i>International Journal of Paleopathology</i>. <b>3</b> (1): <span class="nowrap">64–</span>69. <a href="Bibcode_(identifier)" class="mw-redirect" title="Bibcode (identifier)">Bibcode</a>:<a rel="nofollow" class="external text" href="https://ui.adsabs.harvard.edu/abs/2013IJPal...3...64H">2013IJPal...3...64H</a>. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.ijpp.2013.03.007">10.1016/j.ijpp.2013.03.007</a>. <a href="Hdl_(identifier)" class="mw-redirect" title="Hdl (identifier)">hdl</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://hdl.handle.net/10316%2F44415">10316/44415</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29539362">29539362</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:3916560">3916560</a>.</cite></span>

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<li id="cite_note-23"><span class="mw-cite-backlink"><b><a href="#cite_ref-23">^</a></b></span> <span class="reference-text"><cite id="CITEREFKarakostis2023" class="citation journal cs1">Karakostis, Fotios Alexandros (May 2023). <a rel="nofollow" class="external text" href="https://doi.org/10.1002%2Foa.3196">"Statistical protocol for analyzing 3D muscle attachment sites based on the "Validated Entheses-based Reconstruction of Activity" (VERA) approach"</a>. <i>International Journal of Osteoarchaeology</i>. <b>33</b> (3): <span class="nowrap">461–</span>474. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1002%2Foa.3196">10.1002/oa.3196</a></span>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1047-482X">1047-482X</a>.</cite></span>

</li>

<li id="cite_note-24"><span class="mw-cite-backlink"><b><a href="#cite_ref-24">^</a></b></span> <span class="reference-text"><cite id="CITEREFKarakostisJefferyHarvati2019" class="citation journal cs1">Karakostis FA, Jeffery N, Harvati K (November 2019). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6851080">"Experimental proof that multivariate patterns among muscle attachments (entheses) can reflect repetitive muscle use"</a>. <i>Scientific Reports</i>. <b>9</b> (1) 16577. <a href="Bibcode_(identifier)" class="mw-redirect" title="Bibcode (identifier)">Bibcode</a>:<a rel="nofollow" class="external text" href="https://ui.adsabs.harvard.edu/abs/2019NatSR...916577K">2019NatSR...916577K</a>. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1038%2Fs41598-019-53021-8">10.1038/s41598-019-53021-8</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6851080">6851080</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/31719626">31719626</a>.</cite></span>

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<li id="cite_note-25"><span class="mw-cite-backlink"><b><a href="#cite_ref-25">^</a></b></span> <span class="reference-text"><cite id="CITEREFKarakostisWallaceKonowHarvati2019" class="citation journal cs1">Karakostis FA, Wallace IJ, Konow N, Harvati K (December 2019). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6918778">"Experimental evidence that physical activity affects the multivariate associations among muscle attachments (entheses)"</a>. <i>The Journal of Experimental Biology</i>. <b>222</b> (Pt 23): jeb213058. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1242%2Fjeb.213058">10.1242/jeb.213058</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6918778">6918778</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/31712353">31712353</a>.</cite></span>

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<li id="cite_note-26"><span class="mw-cite-backlink"><b><a href="#cite_ref-26">^</a></b></span> <span class="reference-text"><cite id="CITEREFCastroKarakostisCopesMcClendon2022" class="citation journal cs1">Castro AA, Karakostis FA, Copes LE, McClendon HE, Trivedi AP, Schwartz NE, Garland T (February 2022). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8742976">"Effects of selective breeding for voluntary exercise, chronic exercise, and their interaction on muscle attachment site morphology in house mice"</a>. <i>Journal of Anatomy</i>. <b>240</b> (2): <span class="nowrap">279–</span>295. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1111%2Fjoa.13547">10.1111/joa.13547</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8742976">8742976</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/34519035">34519035</a>.</cite></span>

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<li id="cite_note-27"><span class="mw-cite-backlink"><b><a href="#cite_ref-27">^</a></b></span> <span class="reference-text"><cite id="CITEREFKarakostisWallace2023" class="citation journal cs1">Karakostis, Fotios Alexandros; Wallace, Ian J. (2023-01-31). <a rel="nofollow" class="external text" href="https://doi.org/10.1002%2Fajpa.24700">"Climbing influences entheseal morphology in the humerus of mice: An experimental application of the VERA methodology"</a>. <i>American Journal of Biological Anthropology</i>. <b>181</b>: <span class="nowrap">130–</span>139. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1002%2Fajpa.24700">10.1002/ajpa.24700</a></span>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/2692-7691">2692-7691</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:256486347">256486347</a>.</cite></span>

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</ol></div></div>

<div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2></div>

<ul><li><a rel="nofollow" class="external text" href="http://www.enthesis.info">Enthesis information site</a> at www.enthesis.info</li>

<li><a rel="nofollow" class="external text" href="http://images.medscape.com/pi/editorial/cmecircle/2004/2890/images/slide13.gif">Image of enthesis</a> at <a href="Medscape" title="Medscape">Medscape</a></li>

<li><a rel="nofollow" class="external text" href="http://www.chiroweb.com/archives/18/19/23.html">Enthesopathy and Soft Tissue Shadows</a> at chiroweb.com</li></ul>

<div class="mw-heading mw-heading3"><h3 id="Further_reading">Further reading</h3></div>

<ul><li><cite id="CITEREFResnickNiwayama1983" class="citation journal cs1">Resnick D, Niwayama G (January 1983). "Entheses and enthesopathy. Anatomical, pathological, and radiological correlation". <i>Radiology</i>. <b>146</b> (1): <span class="nowrap">1–</span>9. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1148%2Fradiology.146.1.6849029">10.1148/radiology.146.1.6849029</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/6849029">6849029</a>.</cite></li></ul>

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</style><div id="Bone_and_cartilage47" style="font-size:114%;margin:0 4em"><a href="Bone" title="Bone">Bone</a> and <a href="Cartilage" title="Cartilage">cartilage</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Cartilage" title="Cartilage">Cartilage</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Perichondrium" title="Perichondrium">perichondrium</a></li>

<li><a href="Fibrocartilage_callus" title="Fibrocartilage callus">fibrocartilage callus</a></li>

<li><a href="Metaphysis" title="Metaphysis">metaphysis</a></li>

<li>Cells

<ul><li><a href="Chondroblast" title="Chondroblast">chondroblast</a></li>

<li><a href="Chondrocyte" title="Chondrocyte">chondrocyte</a></li></ul></li>

<li>Types

<ul><li><a href="Hyaline_cartilage" title="Hyaline cartilage">hyaline</a></li>

<li><a href="Elastic_cartilage" title="Elastic cartilage">elastic</a></li>

<li><a href="Fibrocartilage" title="Fibrocartilage">fibrous</a></li></ul></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Bone" title="Bone">Bone</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Ossification" title="Ossification">Ossification</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Primary_bone" title="Primary bone">primary bone</a></li>

<li><a href="Intramembranous_ossification" title="Intramembranous ossification">intramembranous</a></li>

<li><a href="Endochondral_ossification" title="Endochondral ossification">endochondral</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Cells</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Osteoblast" title="Osteoblast">osteoblast</a></li>

<li><a href="Osteocyte" title="Osteocyte">osteocyte</a></li>

<li><a href="Osteoclast" title="Osteoclast">osteoclast</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Matrix</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Bone_mineral" title="Bone mineral">bone mineral</a></li>

<li><a href="Ossein" title="Ossein">ossein</a></li>

<li><a href="Osteoid" title="Osteoid">osteoid</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Types</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Bone#Cancellous_bone" title="Bone">cancellous</a></li>

<li><a href="Bone#Cortical_bone" title="Bone">cortical</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Regions</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Epiphysis" title="Epiphysis">subchondral bone</a></li>

<li><a href="Epiphysis" title="Epiphysis">epiphysis</a></li>

<li><a href="Epiphyseal_plate" title="Epiphyseal plate">epiphyseal plate</a>/<a href="Epiphyseal_line" title="Epiphyseal line">epiphyseal line</a></li>

<li><a href="Metaphysis" title="Metaphysis">metaphysis</a></li>

<li><a href="Diaphysis" title="Diaphysis">diaphysis</a></li>

<li><a href="Condyle" title="Condyle">condyle</a></li>

<li><a href="Epicondyle" title="Epicondyle">epicondyle</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Structure</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Osteon" title="Osteon">osteon</a></li>

<li><a href="Haversian_canal" title="Haversian canal">Haversian canals</a></li>

<li><a href="Volkmann's_canals" class="mw-redirect" title="Volkmann's canals">Volkmann's canals</a></li>

<li><i>connective tissue</i>

<ul><li><a href="Endosteum" title="Endosteum">endosteum</a></li>

<li><a href="Periosteum" title="Periosteum">periosteum</a></li></ul></li>

<li><a href="Sharpey's_fibres" title="Sharpey's fibres">Sharpey's fibres</a></li>

<li><a href="Lacuna_(histology)" title="Lacuna (histology)">lacunae</a></li>

<li><a href="Bone_canaliculus" title="Bone canaliculus">canaliculi</a></li>

<li><a href="Trabecula" title="Trabecula">trabeculae</a></li>

<li><a href="Medullary_cavity" title="Medullary cavity">medullary cavity</a></li>

<li><a href="Bone_marrow" title="Bone marrow">bone marrow</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Shapes</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<li><a href="Short_bone" title="Short bone">short</a></li>

<li><a href="Irregular_bone" title="Irregular bone">irregular</a></li>

<li><a href="Sesamoid_bone" title="Sesamoid bone">sesamoid</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr></tbody></table></div>

<div class="navbox-styles"></div><div role="navigation" class="navbox" aria-labelledby="Joints43" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Joints43" style="font-size:114%;margin:0 4em"><a href="Joint" title="Joint">Joints</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Types</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Fibrous_joint" title="Fibrous joint">Fibrous</a>

<ul><li><a href="Gomphosis" class="mw-redirect" title="Gomphosis">Gomphosis</a></li>

<li><a href="Suture_(joint)" class="mw-redirect" title="Suture (joint)">Suture</a></li>

<li><a href="Syndesmosis" title="Syndesmosis">Syndesmosis</a></li>

<li><a href="Interosseous_membrane" title="Interosseous membrane">Interosseous membrane</a></li></ul></li>

<li><a href="Cartilaginous_joint" title="Cartilaginous joint">Cartilaginous</a>

<ul><li><a href="Synchondrosis" title="Synchondrosis">Synchondrosis</a></li>

<li><a href="Symphysis" title="Symphysis">Symphysis</a></li></ul></li></ul>

<ul><li><i><a href="Synovial_joint" title="Synovial joint">synovial</a>:</i> <a href="Plane_joint" title="Plane joint">Plane joint</a></li>

<li>1°

<ul><li><a href="Hinge_joint" title="Hinge joint">Hinge joint</a></li>

<li><a href="Pivot_joint" title="Pivot joint">Pivot joint</a></li></ul></li>

<li>2°

<ul><li><a href="Condyloid_joint" title="Condyloid joint">Condyloid joint</a></li>

<li><a href="Saddle_joint" title="Saddle joint">Saddle joint</a></li></ul></li>

<li>3°

<ul><li><a href="Ball_and_socket_joint" class="mw-redirect" title="Ball and socket joint">Ball and socket joint</a></li></ul></li></ul>

<ul><li><i><a href="Synostosis" title="Synostosis">synostosis</a></i></li></ul>

<ul><li><i>by range of motion:</i> <a href="Synarthrosis" title="Synarthrosis">Synarthrosis</a></li>

<li><a href="Amphiarthrosis" title="Amphiarthrosis">Amphiarthrosis</a></li>

<li><a href="Synovial_joint" title="Synovial joint">Diarthrosis</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Terminology</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Kinesiology" title="Kinesiology">Kinesiology</a></li>

<li><a href="Anatomical_terms_of_motion" title="Anatomical terms of motion">Anatomical terms of motion</a></li>

<li><a href="Agonist_(muscle)" class="mw-redirect" title="Agonist (muscle)">Agonist</a>/<a href="Antagonist_(muscle)" class="mw-redirect" title="Antagonist (muscle)">Antagonist</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Motions</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><i>general:</i> <a href="Flexion" class="mw-redirect" title="Flexion">Flexion</a>/<a href="Extension_(kinesiology)" class="mw-redirect" title="Extension (kinesiology)">Extension</a></li>

<li><a href="Adduction" class="mw-redirect" title="Adduction">Adduction</a>/<a href="Abduction_(kinesiology)" class="mw-redirect" title="Abduction (kinesiology)">Abduction</a></li>

<li><a href="Internal_rotation" class="mw-redirect" title="Internal rotation">Internal rotation</a>/<a href="External_rotation" class="mw-redirect" title="External rotation">External rotation</a></li>

<li><a href="Elevation_(kinesiology)" class="mw-redirect" title="Elevation (kinesiology)">Elevation</a>/<a href="Depression_(kinesiology)" class="mw-redirect" title="Depression (kinesiology)">Depression</a></li></ul>

<ul><li><i>specialized/upper limbs:</i> <a href="Protraction" class="mw-redirect" title="Protraction">Protraction</a>/<a href="Retraction_(kinesiology)" class="mw-redirect" title="Retraction (kinesiology)">Retraction</a></li>

<li><a href="Supination" class="mw-redirect" title="Supination">Supination</a>/<a href="Pronation" class="mw-redirect" title="Pronation">Pronation</a></li></ul>

<ul><li><i>specialized/lower limbs:</i> <a href="Plantarflexion" class="mw-redirect" title="Plantarflexion">Plantarflexion</a>/<a href="Dorsiflexion" class="mw-redirect" title="Dorsiflexion">Dorsiflexion</a></li>

<li><a href="Eversion_(kinesiology)" class="mw-redirect" title="Eversion (kinesiology)">Eversion</a>/<a href="Inversion_(kinesiology)" class="mw-redirect" title="Inversion (kinesiology)">Inversion</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Components</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><i>capsular:</i> <a href="Joint_capsule" title="Joint capsule">Joint capsule</a>

<ul><li><a href="Synovial_membrane" title="Synovial membrane">Synovial membrane</a></li>

<li><a href="Fibrous_membrane_of_articular_capsule" class="mw-redirect" title="Fibrous membrane of articular capsule">Fibrous membrane</a></li></ul></li>

<li><a href="Synovial_fluid" title="Synovial fluid">Synovial fluid</a></li>

<li><a href="Synovial_bursa" title="Synovial bursa">Synovial bursa</a></li>

<li><a href="Articular_disk" class="mw-redirect" title="Articular disk">Articular disk</a>/<a href="Meniscus_(anatomy)" title="Meniscus (anatomy)">Meniscus</a></li></ul>

<ul><li><i>extracapsular:</i> <a href="Ligament" title="Ligament">Ligament</a></li>

</ul>

</div></td></tr></tbody></table></div></div><div><div class="zim-footer">

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