Chapter 8

Cartilage
Textbook of
Human Histology
Author: Dr Yogesh Sontakke
JIPMER, Pondicherry

Created by
Dr Ujwala Bhanarkar

AIIMS, Kalyani
©CBS Publishers & Distributors Pvt Ltd, New Delhi
 INTRODUCTION
• Specialized connective tissue
• Consists of two basic components
1. Cells (5%)
2. Extracellular matrix (95%)
• Cells of cartilage are called chondrocytes
• Avascular tissue that receives its nutrition by diffusion from adjacent tissues
• Glycosaminoglycans (GAGs) and type II collagen fibers of extracellular matrix
permit easy diffusion of the nutrients through the cartilage
 INTRODUCTION
• Based on composition and mechanical properties of matrix, cartilages are
classified into three types:
1. Hyaline cartilage
2. Elastic cartilage
3. Fibrocartilage
• Cartilages are externally supported by a fibrocellular covering called
perichondrium
 HYALINE CARTILAGE
• Q. Write a short note on histology of hyaline cartilage.
• Hyaline cartilage has glass-like (transparent) matrix
• It is called hyaline cartilage (hyalos = glass, in Greek)
• Locations
−Hyaline cartilage is the most abundant type of cartilage in the human body
− Locations: Fetal skeleton, articular cartilages, nose cartilage, costal cartilages, laryngeal
cartilages (thyroid, cricoid and arytenoids cartilages), trachea and bronchi, and developing
bones (epiphyses)
 Histology of Hyaline Cartilage
• Histologically, hyaline cartilage consists of cells (chondrocytes), ground
substance, and fibers
Fig. 8.1: Molecular organization of ground substance of hyaline cartilage.
Fig. 8.2: Photomicrograph. Hyaline cartilage
Flowchart 8.1: Histology of hyaline cartilage
 Matrix
• Cartilage has glassy appearance − called hyaline
• Spaces called lacunae − cells of cartilage
• Chondrocytes produce sulfated proteoglycans−deposit it in matrix
• According to the concentration of sulfated proteoglycans, matrix shows varied
property of staining with hematoxylin
 Matrix
1. Capsule/pericellular matrix: Ring of densely staining matrix that surrounds the
chondrocytes, high content of negatively charged (acidic) sulfated
proteoglycans, and type VI collagen fibrils
2. Territorial matrix: Surrounds capsular matrix − contains less quantity of sulfated
proteoglycans than capsular matrix, stains less intensely than capsular matrix
3. Interterritorial matrix: Surrounds territorial matrix − contains less quantity of
sulfated proteoglycans, stains lighter with hematoxylin (basic dyes) than
territorial matrix.
Fig. 8.3: Histology of hyaline cartilage (practice figure).
Fig. 8.4: Hyaline cartilage: Matrix and lacunae (practice figure)
Fig. 8.1: Molecular organization of ground substance of hyaline cartilage.
 Some Interesting Facts
• Composition of Matrix
1. 60–80% of intercellular water
2. 15% of collagen fibers, approximately
3. 15% proteoglycans and glycoproteins
4. 3–5% cells
• Contains mainly type II collagen fibers (80%) that form a meshwork in the ground
substances
• Provide strength and stability to cartilage
• Cannot be seen in histological section because refractive indices of the collagen
fibers and the ground substance are same. This gives homogenous glassy-
appearance to cartilage
• Has three types of proteoglycans, hyaluronan, chondroitin sulfate, and keratan
sulfate
 Some Interesting Facts
• Proteoglycans give firmness to cartilage
• Acidic proteoglycans take hematoxylin (violet) color − matrix of hyaline cartilage
looks violet
• Aggrecan is a proteoglycan monomer − consists of a core protein and
peripherally attached chondroitin and keratan sulfate molecules in form of bottle-
brush fashion
• Aggrecan molecule is negatively charged − has the capacity to hold water
molecules (hydrated matrix)
• Matrix shows multiadhesive glycoproteins that help in the interaction between
chondrocytes and matrix
• Hydrated matrix helps in easy diffusion of metabolites and provide resilience to
cartilage
Fig. 8.1: Molecular organization of ground substance of hyaline cartilage.
 Chondrocytes
• Cells of hyaline cartilage
• Chondrocytes divide , deposit matrix around them − chondrocytes occupy
lacunae in matrix
• H&E staining: Chondrocytes lie on one side in lacunae and are surrounded by an
empty space
• Preparation artifact produced because of shrinkage of chondrocytes
• In living state, chondrocyte occupies entire lacunar space
 Chondrocytes
• Cell nests/ isogenous group: Chondrocytes divide to form daughter cells
• Formed cells lie in a group that is surrounded by territorial matrix. Such a group of
daughter chondrocytes raised from a single mother chondrocyte is called
isogenous group
• Isogenous groups form a cell nest (group of cells)
• Derived from chondrocytes that divide mitotically
• Get trapped in self-produced extracellular matrix, lose their capacity of cell
division, and get converted into chondrocytes
 Perichondrium
• Hyaline cartilage is covered by irregular connective tissue
(fibrovascular) layer called perichondrium
• Perichondrium has two layers: outer fibrous and inner cellular layer
1. Outer fibrous layer − consists of dense irregular fibrous connective tissue
2. Inner cellular layer − divide and give rise to new chondrocytes
• Note: Fibrous layer of perichondrium has capillaries that provide
nutrients to interior of the cartilage through diffusion
• Perichondrium is absent at the following sites:
− Articular cartilages
− At the site of direct contact of cartilage with bone
 Functional Correlation of Hyaline Cartilage
• Hyaline cartilages maintain patency of trachea and the main bronchi because of
the firmness
• Because of flexibility, costal cartilages provide support and protection to thoracic
viscera
• Provide smooth surface for the movements
 Some Interesting Facts
• Matrix of cartilage is dynamic, old matrix is removed, and new matrix
is deposited by chondrocytes−internal remodeling.
• Depends on stress and strain on the cartilage
• Has limited and slow growth
• Cartilage shows two types of growth as follows:
− Interstitial growth: It is an addition of new cartilage on its surface −
takes place before maturation (hardening of matrix) of cartilage cells
divide in interstitial growth throughout substance of cartilage
 Some Interesting Facts
− Appositional growth: It is a formation of new cartilage within the
existing cartilage by division of chondrocytes After maturation, cellular
layer of perichondrium deposits new cartilage layers in oppositional
growth
• Cartilage has limited capacity of regeneration
• Hyaline cartilages may ossify with advancing age
• Elastic cartilages do not ossify
• Liver produces somatomedin C that stimulates growth of the
chondrocytes in epiphyseal cartilage
 Clinical Correlation
Osteoarthritis
• One of the common joint diseases that occuring due to injury of
articular cartilage
• Mostly occurs by 65 years of age
• Symptoms: Chronic joint pain particularly in weightbearing joints (hip
joint, knee joint)
• Pathology: Occurs due to decrease in proteoglycan content and
reduction of water content of the cartilage matrix.
• Chondrocytes produce more interleukin 1, and tumor necrotic factor
and less type II collagen, and proteoglycans
• Has no cure. It usually progresses with age
Hyaline Cartilage: Summary (Examination Guide)
• Consists of matrix, cells, and covered by perichondrium
• Basophilic and shows lacunae for chondrocytes
• Matrix has intensely stained capsular (around each chondrocyte), less
intensely stained territorial (around capsular matrix) and lightly
stained interterritorial parts (surround territorial matrix)
• Matrix consists of type II collagen fibers and extracellular ground
substance Ground substance consists of proteoglycans (chondroitin
and keratan sulfates)
Hyaline Cartilage: Summary (Examination Guide)
• Chondrocytes lie within the in lacunae. They produce collagen and
ground substance
• Chondrocytes in developing stage divide to form group of cells that lie
in form of cell clusters called isogenous group or cell nests
• Perichondrium surrounds the cartilage and it has outer fibrous and
inner cellular layers
• Locations: Nasal septum, tracheal rings, articular cartilages, costal
cartilages, and fetal skeleton
 ELASTIC CARTILAGE
• Q. Write a short note on histology of elastic cartilage.
• Gives resilience, pliability, and elasticity to the organ
• Freshly dissected elastic cartilage is yellowish in color; hence, it is
also called yellow elastic cartilage
• Locations: Elastic cartilage is present in pinna of external ear, walls of
external acoustic meatus, auditory tube, epiglottis, tips of arytenoids,
corniculate, and cuneiform cartilages of larynx
 Histology of Elastic Cartilage
• Elastic cartilage contains ground substance, fibers, and cells
(chondrocytes)
• Elastic cartilage is surrounded by perichondrium
Fig. 8.5: Histology of elastic cartilage (practice figure).
Fig. 8.6: Photomicrograph. Elastic cartilage (low magnification on left and high magnification on right, H&E stain).
Flowchart 8.2: Histology of elastic cartilage
 Fibers
Elastic cartilage
• Contains a dense meshwork of branching and anastomosing fine elastic
• Imparts yellow color to the cartilage
• This cartilage also contains few type II collagen fibers
• Cannot be differentiated with H&E staining
• Well demonstrated with orcein or resorcin-fuchsin staining
 Ground Substance
• Similar to hyaline cartilage, elastic cartilage also contains proteoglycans and
glycoproteins in matrix
 Chondrocytes
• Chondrocytes (cells of elastic cartilage) occupy lacunae (space within
matrix)
• Cells in elastic cartilage>the cells in hyaline cartilage
• Cells are surrounded by empty space (lacuna) due to shrinkage of
cells during slide preparation (preparation artifacts). In living state,
cells occupy complete lacunae
• Chondrocytes produce elastic fibers, collagen fibers, and ground
substance
• Lie singly or in a group of two
 Perichondrium
• Free surface of elastic cartilage is covered by irregular connective
tissue (fibrovascular) layer called perichondrium
• Has two layers:
1. Outer fibrous
2. Inner cellular layer
• Outer fibrous layer of perichondrium consists of dense irregular
fibrous connective tissue
• Inner cellular layer has cells that divide and give rise to new
chondrocytes
 Functional Correlation of Elastic Cartilage
• Elastic cartilage provides elasticity, resilience, and firmness to the structure
Elastic Cartilage: Summary (Examination Guide)
• Matrix cells covered by perichondrium.
• Matrix shows meshwork of branching anastomosing elastic fibers and
ground substance that consists of proteoglycans
• Large chondrocytes occupy lacunae in matrix. Chondrocytes lie singly
or in group of two
• Perichondrium surrounds cartilage and it has two layers:
• Outer fibrous and inner cellular
• Locations: Pinna of external ear, external acoustic meatus, auditory
tube, epiglottis, tips of arytenoids, and corniculate and cuneiform
cartilages of larynx
 FIBROCARTILAGE
• Q. Write a short note on histology of white fibrocartilage
• Contains bundles of thick collagen fibers that give white color to
cartilage−called white fibrocartilage
• Combination of dense regular connective tissue and hyaline cartilage
• Locations: Intervertebral discs, pubic symphysis, articular disc of
sternoclavicular and temporomandibular joints, menisci, glenoidal
labrum, acetabular labrum, articular disc of wrist joint, and at the site
of tendon attachment with bones (few places)
 Histology of Fibrocartilage
• Histologically, fibrocartilage shows rows of chondrocytes embedded in
matrix bundles of thick collagen fibers
Fig. 8.7: Histology of white fibrocartilage.
Fig. 8.8: Photomicrograph. White fibrocartilage.
Flowchart 8.3: Histology of fibrocartilage
 Fibers
• Consists of thick collagen fibers that form dense regular connective
tissue of type I and type II collagen fibers in varying proportions
• Some fibroblasts are present among collagen fibers
• Flat elongated nuclei
 Chondrocytes
• Few in number in fibrocartilage
• Lie singly or in isogenous groups in between bundles of collagen
fibers
 Matrix
• Lie within the lacunae of the matrix
• Produce matrix that consists of proteoglycans and glycoproteins
• Note: Fibrocartilage does not have periosteum
• Note: Histologically, tendon can be differentiated from fibrocartilage
on the basis of chondrocytes that are present in fibrocartilage.
Fibrocartilage is not covered by perichondrium
 Functional Correlation of Fibrocartilage
• Helps in shock absorption
• Helps to withstand compression and shearing forces
Fibrocartilage: Summary (Examination Guide)
• Consists of dense regular connective tissue with interspaced rows of
chondrocytes−does not have perichondrium
• Contains type I and II collagen fibrils and few fibroblasts
• Lie single or in rows within the lacunae in the matrix
• Locations: Intervertebral discs, menisci of knee joint, and pubic
symphysis
 Some Interesting Facts
• Note: Proteoglycans secreted by chondrocytes are aggrecan,
whereas proteoglycans secreted by fibroblasts are versican
• Cartilage − limited capacity of repair because cartilage is an
avascular structure
• Chondrocytes cannot move to the site of injury because of matrix
• Perichondral injuries may get repaired easily by formation of scar
tissue (dense connective tissue)
• Calcification of hyaline cartilage: On aging, calcium salts get
deposited in matrix of hyaline cartilage. This calcium reduces diffusion
through cartilage and thus, causes death of chondrocytes. Such
cartilage segment gets replaced by bone (ossification)
 Some Interesting Facts
• Chondroclast removes cartilage in many joint diseases such as
rheumatoid arthritis
• New concept: Chondroclast (similar to osteoclast) do not remove
cartilage during ossification
• Previous concept: During ossification of hyaline cartilage,
chondroclasts remove cartilage
• Cellular cartilage: Cellular cartilage is seen during embryonic life
• It consists of numerous cells and minimal matrix
• Differences between hyaline, elastic and fibrocartilages are listed in
Table 8.1
Q. List the differences between hyaline cartilage, elastic cartilage, and fibrocartilage

Table 8.1: Difference between hyaline, elastic, and fibrocartilages

Features Hyaline cartilage Elastic cartilage Fibrocartilage
Cells Chondroblasts and Chondroblasts and Few fibroblasts,
chondrocytes chondrocytes few chondrocytes
Cell occurrence Lies in groups (cell Lie single or in a Lie single or in a
nests) group of two row
Fibers Type II collagen Elastic fibers and Type I and type II
fibers few type II collagen collagen fibers
fibers
Perichondrium Present Present Absent

Production of By chondrocytes By chondrocytes By chondrocytes

ground substance and by fibroblasts
 Clinical Correlation
• Achondroplasia/dwarfism
• Autosomal dominant genetic disorder that is recognized by short legs
and arms and normal torso
• Cause: Mutation of fibroblast growth factor receptor 3 (FGFR3) gene
• Pathogenesis: Defective proteins interfere in the conversion of
cartilage in bone
• New concept: Achondroplasia is transmitted only from father
• Chondrosarcoma: It is a malignant tumor of chondroblasts that
develops usually in bones of axial skeleton
Thank you…