Joint

Last updated
Joint
Joint.svg
Diagram of a typical synovial joint
Gray298.png
Details
System Musculoskeletal system
Articular system
Identifiers
Latin articulus,
junctura,
articulatio
MeSH D007596
TA98 A03.0.00.000
TA2 1515
FMA 7490
Anatomical terminology

A joint or articulation (or articular surface) is the connection made between bones, ossicles, or other hard structures in the body which link an animal's skeletal system into a functional whole. [1] [2] [3] They are constructed to allow for different degrees and types of movement. Some joints, such as the knee, elbow, and shoulder, are self-lubricating, almost frictionless, and are able to withstand compression and maintain heavy loads while still executing smooth and precise movements. [3] Other joints such as sutures between the bones of the skull permit very little movement (only during birth) in order to protect the brain and the sense organs. [3] The connection between a tooth and the jawbone is also called a joint, and is described as a fibrous joint known as a gomphosis. Joints are classified both structurally and functionally. [4]

Contents

Joints play a vital role in the human body, contributing to movement, stability, and overall function. They are essential for mobility and flexibility, connecting bones and facilitating a wide range of motions, from simple bending and stretching to complex actions like running and jumping. Beyond enabling movement, joints provide structural support and stability to the skeleton, helping to maintain posture, balance, and the ability to bear weight during daily activities.

The clinical significance of joints is highlighted by common disorders that affect their health and function. Osteoarthritis, a degenerative joint disease, involves the breakdown of cartilage, leading to pain, stiffness, and reduced mobility. Rheumatoid arthritis, an autoimmune disorder, causes chronic inflammation in the joints, often resulting in swelling, pain, and potential deformity. Another prevalent condition, gout, arises from the accumulation of uric acid crystals in the joints, triggering severe pain and inflammation.

Joints also hold diagnostic importance, as their condition can indicate underlying health issues. Symptoms such as joint pain and swelling may signal inflammatory diseases, infections, or metabolic disorders. Effective treatment and management of joint-related conditions often require a multifaceted approach, including physical therapy, medications, lifestyle changes, and, in severe cases, surgical interventions. Preventive care, such as regular exercise, a balanced diet, and avoiding excessive strain, is critical for maintaining joint health, preventing disorders, and improving overall quality of life.

Classification

The number of joints depends on if sesamoids are included, age of the human and the definition of joints. However, the number of sesamoids is the same in most people with variations being rare. [5] [6] [7]

Joints are mainly classified structurally and functionally. Structural classification is determined by how the bones connect to each other, while functional classification is determined by the degree of movement between the articulating bones. In practice, there is significant overlap between the two types of classifications.

Clinical, numerical classification

Structural classification (binding tissue)

Types of joints based upon their structure (L to R): cartilaginous joint, fibrous joint, and synovial joint. Structural Classification of Joints.jpg
Types of joints based upon their structure (L to R): cartilaginous joint, fibrous joint, and synovial joint.

Structural classification names and divides joints according to the type of binding tissue that connects the bones to each other. [1] There are four structural classifications of joints: [8]

Functional classification (movement)

Joints can also be classified functionally according to the type and degree of movement they allow: [1] [12] Joint movements are described with reference to the basic anatomical planes. [3]

Joints can also be classified, according to the number of axes of movement they allow, into nonaxial (gliding, as between the proximal ends of the ulna and radius), monoaxial (uniaxial), biaxial and multiaxial. [17] Another classification is according to the degrees of freedom allowed, and distinguished between joints with one, two or three degrees of freedom. [17] A further classification is according to the number and shapes of the articular surfaces: flat, concave and convex surfaces. [17] Types of articular surfaces include trochlear surfaces. [18]

Biomechanical classification

Joints can also be classified based on their anatomy or on their biomechanical properties. According to the anatomic classification, joints are subdivided into simple and compound, depending on the number of bones involved, and into complex and combination joints: [19]

  1. Simple joint: two articulation surfaces (e.g. shoulder joint, hip joint)
  2. Compound joint: three or more articulation surfaces (e.g. radiocarpal joint)
  3. Complex joint: two or more articulation surfaces and an articular disc or meniscus (e.g. knee joint)

Anatomical

Joints of the human body Joints 1 -- Smart-Servier.png
Joints of the human body

The joints may be classified anatomically into the following groups:

  1. Joints of hand
  2. Elbow joints
  3. Wrist joints
  4. Axillary joints
  5. Sternoclavicular joints
  6. Vertebral articulations
  7. Temporomandibular joints
  8. Sacroiliac joints
  9. Hip joints
  10. Knee joints
  11. Articulations of foot

Unmyelinated nerve fibers are abundant in joint capsules and ligaments, as well as in the outer part of intra-articular menisci. These nerve fibers are responsible for pain perception when a joint is strained. [20]

Clinical significance

Damaging the cartilage of joints (articular cartilage) or the bones and muscles that stabilize the joints can lead to joint dislocations and osteoarthritis. Swimming is a great way to exercise the joints with minimal damage. [3]

A joint disorder is termed arthropathy, and when involving inflammation of one or more joints the disorder is called arthritis. Most joint disorders involve arthritis, but joint damage by external physical trauma is typically not termed arthritis.

Arthropathies are called polyarticular (multiarticular) when involving many joints and monoarticular when involving only a single joint.

Arthritis is the leading cause of disability in people over the age of 55. There are many different forms of arthritis, each of which has a different cause. The most common form of arthritis, osteoarthritis (also known as degenerative joint disease), occurs following trauma to the joint, following an infection of the joint or simply as a result of aging and the deterioration of articular cartilage. Furthermore, there is emerging evidence that abnormal anatomy may contribute to early development of osteoarthritis. Other forms of arthritis are rheumatoid arthritis and psoriatic arthritis, which are autoimmune diseases in which the body is attacking itself. Septic arthritis is caused by joint infection. Gouty arthritis is caused by deposition of uric acid crystals in the joint that results in subsequent inflammation. Additionally, there is a less common form of gout that is caused by the formation of rhomboidal-shaped crystals of calcium pyrophosphate. This form of gout is known as pseudogout.

Temporomandibular joint syndrome (TMJ) involves the jaw joints and can cause facial pain, clicking sounds in the jaw, or limitation of jaw movement, to name a few symptoms. It is caused by psychological tension and misalignment of the jaw (malocclusion), and may be affecting as many as 75 million Americans. [3]

History

Etymology

The English word joint is a past participle of the verb join, and can be read as joined. [21] Joint is derived from Latin iunctus, [21] past participle of the Latin verb iungere, join, unite, connect, attach. [22]

The English term articulation is derived from Latin articulatio. [21]

Humans have also developed lighter, more fragile joint bones over time due to the decrease in physical activity compared to thousands of years ago. [23]

See also

Related Research Articles

<span class="mw-page-title-main">Cartilage</span> Resilient and smooth elastic tissue present in animals

Cartilage is a resilient and smooth type of connective tissue. Semi-transparent and non-porous, it is usually covered by a tough and fibrous membrane called perichondrium. In tetrapods, it covers and protects the ends of long bones at the joints as articular cartilage, and is a structural component of many body parts including the rib cage, the neck and the bronchial tubes, and the intervertebral discs. In other taxa, such as chondrichthyans and cyclostomes, it constitutes a much greater proportion of the skeleton. It is not as hard and rigid as bone, but it is much stiffer and much less flexible than muscle. The matrix of cartilage is made up of glycosaminoglycans, proteoglycans, collagen fibers and, sometimes, elastin. It usually grows quicker than bone.

<span class="mw-page-title-main">Knee</span> Leg joint in primates

In humans and other primates, the knee joins the thigh with the leg and consists of two joints: one between the femur and tibia, and one between the femur and patella. It is the largest joint in the human body. The knee is a modified hinge joint, which permits flexion and extension as well as slight internal and external rotation. The knee is vulnerable to injury and to the development of osteoarthritis.

<span class="mw-page-title-main">Temporomandibular joint</span> Joints connecting the jawbone to the skull

In anatomy, the temporomandibular joints (TMJ) are the two joints connecting the jawbone to the skull. It is a bilateral synovial articulation between the temporal bone of the skull above and the condylar process of mandible below; it is from these bones that its name is derived. The joints are unique in their bilateral function, being connected via the mandible.

<span class="mw-page-title-main">Wrist</span> Part of the arm between the lower arm and the hand

In human anatomy, the wrist is variously defined as (1) the carpus or carpal bones, the complex of eight bones forming the proximal skeletal segment of the hand; (2) the wrist joint or radiocarpal joint, the joint between the radius and the carpus and; (3) the anatomical region surrounding the carpus including the distal parts of the bones of the forearm and the proximal parts of the metacarpus or five metacarpal bones and the series of joints between these bones, thus referred to as wrist joints. This region also includes the carpal tunnel, the anatomical snuff box, bracelet lines, the flexor retinaculum, and the extensor retinaculum.

<span class="mw-page-title-main">Patella</span> Kneecap, bone covering knee joint

The patella, also known as the kneecap, is a flat, rounded triangular bone which articulates with the femur and covers and protects the anterior articular surface of the knee joint. The patella is found in many tetrapods, such as mice, cats, birds and dogs, but not in whales, or most reptiles.

<span class="mw-page-title-main">Synovial joint</span> Articulation which admits free motion in the joint; the most common type of articulation

A synovial joint, also known as diarthrosis, join bones or cartilage with a fibrous joint capsule that is continuous with the periosteum of the joined bones, constitutes the outer boundary of a synovial cavity, and surrounds the bones' articulating surfaces. This joint unites long bones and permits free bone movement and greater mobility. The synovial cavity/joint is filled with synovial fluid. The joint capsule is made up of an outer layer of fibrous membrane, which keeps the bones together structurally, and an inner layer, the synovial membrane, which seals in the synovial fluid.

<span class="mw-page-title-main">Human musculoskeletal system</span> Organ system that gives humans the capacity to move by using their muscular and skeletal systems

The human musculoskeletal system is an organ system that gives humans the ability to move using their muscular and skeletal systems. The musculoskeletal system provides form, support, stability, and movement to the body.

<span class="mw-page-title-main">Hyaline cartilage</span> Type of cartilage in animals

Hyaline cartilage is the glass-like (hyaline) and translucent cartilage found on many joint surfaces. It is also most commonly found in the ribs, nose, larynx, and trachea. Hyaline cartilage is pearl-gray in color, with a firm consistency and has a considerable amount of collagen. It contains no nerves or blood vessels, and its structure is relatively simple.

<span class="mw-page-title-main">Synovial osteochondromatosis</span> Medical condition

Synovial osteochondromatosis (SOC) (synonyms include synovial chondromatosis, primary synovial chondromatosis, synovial chondrometaplasia) is a rare disease that creates a benign change or proliferation in the synovium or joint-lining tissue, which changes to form bone-forming cartilage. In most occurrences, there is only one joint affected, either the knee, the hip, or the elbow. Rarely involves the TMJ.

<span class="mw-page-title-main">Meniscus (anatomy)</span> Fibrocartilaginous part of a bone joint

A meniscus is a crescent-shaped fibrocartilaginous anatomical structure that, in contrast to an articular disc, only partly divides a joint cavity. In humans, they are present in the knee, wrist, acromioclavicular, sternoclavicular, and temporomandibular joints; in other animals they may be present in other joints.

<span class="mw-page-title-main">Carpometacarpal joint</span> Joint between the wrist and hand

The carpometacarpal (CMC) joints are five joints in the wrist that articulate the distal row of carpal bones and the proximal bases of the five metacarpal bones.

<span class="mw-page-title-main">Shoulder girdle</span> Set of bones which connects the arm to the axial skeleton on each side

The shoulder girdle or pectoral girdle is the set of bones in the appendicular skeleton which connects to the arm on each side. In humans, it consists of the clavicle and scapula; in those species with three bones in the shoulder, it consists of the clavicle, scapula, and coracoid. Some mammalian species have only the scapula.

<span class="mw-page-title-main">Joint capsule</span> Anatomical structure on synovial joints

In anatomy, a joint capsule or articular capsule is an envelope surrounding a synovial joint. Each joint capsule has two parts: an outer fibrous layer or membrane, and an inner synovial layer or membrane.

<span class="mw-page-title-main">Sternoclavicular joint</span> Joint between the manubrium of the sternum and the clavicle bone

The sternoclavicular joint or sternoclavicular articulation is a synovial saddle joint between the manubrium of the sternum, and the clavicle, and the first costal cartilage. The joint possesses a joint capsule, and an articular disc, and is reinforced by multiple ligaments.

<span class="mw-page-title-main">Intercarpal joints</span> Joints of the carpal bones of the wrist

The intercarpal joints can be subdivided into three sets of joints : Those of the proximal row of carpal bones, those of the distal row of carpal bones, and those of the two rows with each other.

<span class="mw-page-title-main">Proteoglycan 4</span> Proteoglycan; lubricant; gene

Proteoglycan 4 or lubricin is a proteoglycan that in humans is encoded by the PRG4 gene. It acts as a joint/boundary lubricant.

<span class="mw-page-title-main">Facet syndrome</span> Medical condition

Facet syndrome is a syndrome in which the facet joints cause painful symptoms. In conjunction with degenerative disc disease, a distinct but functionally related condition, facet arthropathy is believed to be one of the most common causes of lower back pain.

<span class="mw-page-title-main">Hip pain</span>

Pain in the hip is the experience of pain in the muscles or joints in the hip/ pelvic region, a condition commonly arising from any of a number of factors. Sometimes it is closely associated with lower back pain.

<span class="mw-page-title-main">Polysulfated glycosaminoglycan</span> Injectable drug

Polysulfated glycosaminoglycan (PSGAG), sold under the brand name Adequan, is an injectable drug for dogs and horses that is used to alleviate the limpness, pain, and lowered range of motion caused by arthritis. It is made of repeat disaccharide units (comprising hexosamine and hexuronic acid), and is similar to glycosaminoglycans already present in the cartilage; PSGAG thus easily integrates itself there. In vitro studies have shown it to inhibit the enzymes that degrade cartilage and bone, as well as suppress inflammation and stimulate the synthesis of replacement cartilage. While it can cause an increased risk of bleeding, it is relatively safe and has a high LD50. PSGAG is one of the most widely prescribed joint treatments for horses.

Radiosynoviorthesis (RSO) is a minimally invasive therapeutic procedure for managing joint inflammation, particularly synovitis associated with osteoarthritis. Radiosynoviorthesis involves the intra-articular injection of radioactive isotopes to specifically treat the inflamed synovial membrane. Synovitis, a hallmark of various joint disorders, including osteoarthritis, manifests as inflammation within the synovial membrane lining the joints. RSO aims to suppress overactive macrophage and synovial cells responsible for the inflammatory response, providing relief from pain and improving joint functionality.

References

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