10/12/2025
Muscle or Fascial System Lesion (Part I): Understanding the Continuum From Micro to Macro From a Clinical Perspective
Tendon: “From a hierarchical perspective, the tendon exhibits a histological and architectural organization similar to that of skeletal muscle. However, there is no clear terminological or structural equivalence with IMCT.
The tendon is externally covered along its entire length by the epitenon, a layer of loose connective tissue that serves as a smooth gliding surface for the tendon fascicles and also provides supply routes for the nervous and lymphatic systems of the tendon.
Internally, the endotenon (which is the basal membrane containing type IV and VI collagen) surrounds each tendon fiber and also links individual fibers into larger units that form the tendon fascicle (Figure 4). Toward the outside, the endotenon continues into the epitenon.”
- Saverio Colonna • Fabio Casacci • Paolo MInafra
Figure 4: Schematic representation of tendon structure.
The picture shows the subdivision into primary, secondary, and tertiary subunits, along with the organization of the endotenon, epitenon, and paratenon.
Image Credit: Saverio Colonna. Original figure created by the author; no permission required.
Cureus, Inc.
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