Not necessarily. While a high proportion of COX-negative fibers can be indicative of pathology, a few COX-negative fibers can also be found in healthy individuals, especially as they age. It is the relative number and distribution of these fibers, along with clinical context and other diagnostic findings, that determine their pathological significance. Therefore, the presence of COX-negative fibers must be interpreted with caution and in conjunction with other clinical and laboratory data.
