Mucoid change

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Mucoid change or mucoid degeneration refers to the irreversible tissue degeneration due to the accumulation of mucin within the fibers of tendons, ligaments, and fibrocartilage.

Epidemiology

The likelihood of mucoid change within ligaments and tendons increases with age .

Risk factors

Predisposing factors include the following :

  • aging
  • mechanical repetitive stress
  • traumatic injury
Associations

Mucoid change is associated with the following conditions :

Clinical presentation

The clinical presentation mucoid change and includes pain, restricted range of motion and stiffness dependent on the localization .

Complications

Complications of mucoid change include the following :

Pathology

Histologically mucoid change is characterized by the degradation and disorganization of collagen fibers and the deposition of a mucoid substance containing new glycosaminoglycans within those fibers .

Location

Tendons and ligaments and fibrocartilage can be affected by the mucoid change, in particular, the following :

Radiographic features

Mucoid change can be seen on ultrasound or MRI.

US

Hypoechoic foci are seen within or replacing the fibrillar architecture of tendons or ligaments, which might be surrounded by hyperemia on color or power Doppler .

MRI

Ligaments and tendons affected by mucoid change might display a thickened and/or ill-defined appearance characterized by nonspecific linear or globular increase in signal intensity.

Signal characteristics

Mucoid change shows increased signal intensity on all pulse sequences typically easily definable on T2 weighted and fat-saturated images, but poorly distinguishable on non-fat saturated PD weighted images .

T1/PD: intermediate to mildly hyperintense

T2/T2FS/PDFS: hyperintense

Radiology report

The radiological report should include a description of the following:

  • location of the mucoid change within tendons and/or ligaments
  • any associated partial or complete tears
  • signs of impingement
  • associated findings as degenerative joint disease

Treatment and prognosis

Treatment is only required if there are otherwise unexplained symptoms. It is then conservative and includes exercise therapy, activity modification, physical and manual therapy as well as nonsteroidal antiinflammatory drugs .

Surgical treatment options depend on the specific location and include debridement and or partial excision in patients with refractory severe symptoms and impingement unresponsive to conservative treatment options .

Differential diagnosis

Conditions which can mimic the presentation and/or the appearance of mucoid change include :

See also

Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu mucoid degeneration: