How are joints arranged? Bobyr Clinic

Joints or joints/articular surfaces are the connections between bones in the body that link the skeletal system into a functional whole. They are designed to accommodate different degrees and types of movement and are classified both by design features and functionality. Some joints, such as the knee, elbow and shoulder, are self-lubricating, i.e. move almost without friction, and are able to withstand heavy loads, while allowing for smooth and precise movements. Other joints, such as the sutures between the bones of the skull, allow very little movement (during childbirth), which helps protect the brain and sensory organs located in the cranium. The connection between the tooth and the jawbone is also called a joint, known as a gomphosis.

The science of the structure, functions and dysfunctions of joints is called arthrology.

Joints are generally divided into two categories: synarthrodic joints or synarthroses (no or very little movement) and diarthrodic joints or diarthroses, also called synovial joints (large range of motion).

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Synarthrodial joints

Syndesmosis (bones connected through connective tissue).
Synchondrosis (via cartilage tissue).

Diarthrodial joints

Single-axle.
Two-axle.
Three-axle.

What is fluid accumulation in a joint?

The accumulation of fluid in the joint is considered one of the symptoms of hydrarthrosis or dropsy - a peculiar syndrome in which the volume of the joint increases due to the formation of synovial fluid in its cavity.
Most often, this syndrome is observed in the knee joint, less often in the ankle, elbow and others. In this case, there may be a restriction in joint flexion; the intensity of pain depends on the amount of fluid and the degree of stretching of the joint capsule. An increase in local temperature is not observed unless the inflammatory process has begun.

Fibrous joints

In the case of fibrous joints (synarthrosis), the bones are connected through fibrous tissue, namely through dense fibrous connective tissue, and there is no joint cavity. The amount of movement allowed depends on the length of the connective tissue fibers connecting the bones. Although some are slightly mobile, most fibrous joints are immobile.

There are three types of fibrous joints: sutures, syndesmoses and gomphoses.

Seams

Skull sutures

Fixed or slightly mobile fibrous joints in which short collagen fibers connect the bones of the skull to each other.

Seams can be classified as:

Serrated: interlacing wavy lines (coronal, sagittal and lambdoid sutures).
Squamosal: overlapping beveled edges (temporal and parietal bones).
Flat: straight, non-overlapping edges (alveolar processes of the maxilla).

Gomphoses

The attachment of a tooth to its socket, held in place by the fibrous periodontal ligament, made up of collagen fibers. This connection attaches the tooth to the jawbone, allowing it to move slightly during chewing.

Syndesmosis

Fibrous joints (sutures, syndesmosis, gomphosis)

A fibrous joint in which two bones are connected by long collagen fibers. The separation between the bones and the length of the fibers give these joints slightly greater mobility compared to sutures and gomphoses.

An example of a very mobile syndesmosis: the interosseous membrane of the forearm, connecting the radius to the ulna, allows supination and pronation of the hand
An example of a less mobile syndesmosis: the articulation between the tibia and fibula.

Causes

The accumulation of fluid in a joint can be a consequence of a disease, but the most common cause is injury. These include:

Injury – sprain, ligament rupture. This can lead to a buildup of fluid that becomes infected after a viral illness.
Various joint diseases, including gout or arthritis.
Lupus erythematosus.
Bursitis, which is common in dancers or athletes.
Incoagulability of blood and others.

Important! These reasons must be mentioned when visiting a doctor, this will help to correctly establish a diagnosis and prescribe competent treatment.

Synovial joints

The structure of the synovial joint

Diarthrosis or diarthrodial joint is a joint in which the articular bones are separated by a joint cavity containing fluid. This arrangement allows significant freedom of movement, and all synovial joints are freely movable diarthrosis. They are the most structurally complex type of joint and are most susceptible to the development of a variety of dysfunctions. Almost all joints of the limbs and most joints of the body belong to this class of joints.

General anatomy of synovial joints

Articular cartilage. Glassy-smooth hyaline cartilage covers the opposing surfaces of the bones. These thin (1 mm or less) but spongy pads absorb the stress (compression) that occurs in the joint and thereby protect the ends of the bones from being crushed.
Articular (synovial) cavity. A feature unique to synovial joints is that the joint cavity is actually just a potential space containing a small amount of synovial fluid.
Joint capsule. The joint cavity is closed by a two-layer articular capsule. The outer capsule layer is a tough fibrous structure consisting of dense irregular connective tissue that continuously fuses with the periosteum of the articulating bones. It strengthens the joint so that the articular surfaces of the articulating bones do not move away from each other. The inner layer of the joint capsule is a synovial membrane consisting of loose connective tissue. In addition to the internal lining of the fibrous capsule, it covers all internal articular surfaces that are not hyaline cartilage.
Synovial fluid. A small amount of slippery synovial fluid occupies all the free spaces inside the joint capsule. This fluid is formed mainly by filtration from the blood flowing through the capillaries of the synovium. Synovial fluid has a viscous, egg-white consistency due to hyaluronic acid secreted by the cells of the synovial membrane. However, it becomes less viscous as the joint moves.
Strengthening ligaments. Synovial joints are strengthened and strengthened by ligaments. Most often these are capsular, or internal, ligaments, which are thickened parts of the fibrous capsule. In other cases, they remain distinct and are found outside the capsule (as extracapsular ligaments) or deep within it (as intracapsular ligaments). Since the intracapsular ligaments are covered by a synovial membrane, they do not actually lie in the joint cavity.
Nerves and blood vessels. Synovial joints are abundantly supplied with sensory nerve fibers innervating the capsule. Some of these fibers detect pain, as anyone who has suffered a joint injury knows, but most sense the position of the joint and stretch, thus helping to maintain muscle tone. The stretching of these structures sends nerve impulses to the central nervous system, which leads to a reflex contraction of the muscles surrounding the joint. Synovial joints are also abundantly supplied with blood vessels, most of which nourish the synovial membrane. There, extensive capillary beds produce blood filtrate, which is the basis of synovial fluid.

In addition to the main components described above, some synovial joints have other structural features. Some, such as the hip and knee joints, have cushioning fat pads between the fibrous capsule and the synovium or bone. Others have discs or wedges of fibrocartilage (menisci) separating the articular surfaces. Where present, these so-called articular discs or menisci extend inward from the joint capsule and partially or completely divide the synovial cavity into two parts. Articular discs improve congruence between the articular ends of bones, making the joint more stable and minimizing wear and tear on the articular surfaces. In addition to the knee joints, articular discs are found in the temporomandibular joints and some other joints.

Classification

The fluid that accumulates in the joint cavity can be classified by its nature into exudate and transudate. Accordingly, exudate is associated with the occurrence of inflammatory processes and comes in several types:

Serous.
Purulent.
Hemorrhagic.
Frail.

Transudate is formed for other reasons that are not related to inflammation, but are associated with circulatory disorders and other abnormalities.

Pathologies

The accumulation of fluid in the joints is a health hazard and can lead to the development of the following pathologies:

Hemarthrosis is formed due to damage and blood flow into the joint.
Arthrosis is the most common pathology and occurs as a result of mechanical damage or age-related changes.
Arthritis can occur for a variety of reasons, including infections or allergic reactions.
Synovitis is an inflammatory disease.
Bursitis can develop due to injury or after an infectious disease.

What causes joint damage?

1. Excess weight. Excess weight puts excessive stress on joints and leads to their destruction. 2. Poor nutrition. A lack of minerals and protein in the diet prevents joint tissue from recovering. 3. Incorrect posture. A sedentary lifestyle and monotonous, monotonous movements lead to joint destruction. 4. Uncomfortable shoes. Incorrectly chosen shoes increase the load on the joints of the legs and cause their diseases. 5. Excessive physical activity. Impact loads, injuries and violations of safety regulations during sports lead to the destruction of joints. 6. In addition, joints are affected by arthritis - the consequences of inflammation or age-related destruction of joint tissue. Find out more about how to keep your joints healthy and what you can do about it right now.

Diagnosis of the causes of fluid accumulation in the joint

Diagnosis of this pathology consists of an initial examination of the patient by a specialist, for example, an orthopedist or traumatologist. After an external examination, palpation and questioning of the patient, the doctor makes a preliminary diagnosis and refers the patient for additional examination for clarification:

x-ray,
Ultrasound of the joint,
MRI of the joint
joint puncture and others.

Reference! To identify hidden infections, a general or extended blood test, ECG and blood type identification may be needed.

After carefully studying the examination data, the specialist will prescribe comprehensive treatment depending on the cause of the disease.

Which doctor treats fluid accumulation in a joint?

The accumulation of fluid in the joint is considered a fairly common problem, which, even in the absence of pronounced symptoms, requires immediate seeking qualified medical help. Like treatment of the spine, fluid removal from the joint cavity should be done immediately after the problem is discovered. You need to contact an orthopedic traumatologist who specializes in diseases of the musculoskeletal system and rehabilitation after surgical interventions.

In our Kuntsevo treatment and rehabilitation center, you will not only receive qualified assistance from experienced orthopedic traumatologists if fluid is detected in the joints, but you will also be able to undergo a full examination using the latest diagnostic equipment and, if necessary, recover in our rehabilitation center after injuries according to a specially developed comprehensive program .

The accumulation of fluid in the joint significantly reduces the patient’s quality of life. As a rule, a person cannot fully perform movements and complains of pain and discomfort in the joint area.

Important! This symptom cannot be ignored, because the progression of the pathology can lead to the development of chronic inflammatory joint diseases.

At the first signs of pathology, make an appointment with a qualified doctor - orthopedic traumatologist at the Kuntsevo Treatment and Rehabilitation Center, who will be able to fully examine the joint, find the source of the pathology and prescribe the correct treatment, in particular at the rehabilitation stage.

Types of synovial joints

Types of joints

Although all synovial joints share structural features, they do not share a common structural plan. Based on the shape of the articular surfaces, which in turn determine the permissible movements, synovial joints can be divided into six main categories (planar, trochlear, rotary, ellipsoidal, saddle and ball-and-socket joints).

Flat joints

Intermetatarsal joints

A multi-axial joint, the articular surfaces are predominantly flat and allow only short, non-axial sliding movements. Examples include the intercarpal and intermetatarsal joints, as well as the joints between the articular processes of the vertebrae. Sliding does not involve rotation about any axis, and sliding joints are the only examples of non-axial planar joints.

Block joints

Elbow joint

Uniaxial joints, the cylindrical end of one bone matches the groove-like surface on the other. The movement occurs along one plane and resembles the movement of a mechanical hinge. Uniaxial hinge joints allow only flexion and extension, characteristic of flexion and straightening of the elbow and interphalangeal joints.

Cylindrical joints

Atlantoaxial joint

Uniaxial joints, the rounded end of one bone fits into a ring made up of bone (and possibly ligaments) of the other. The only permissible movement is uniaxial rotation of one bone around its own long axis. An example is the articulation between the atlas and the axis tooth, which allows the head to be moved from side to side to say “no.” Another example is the proximal radioulnar joint, where the head of the radius rotates within the annular ligament attached to the ulna.

Ellipsoid joints

Carpal joint

Biaxial joints. The oval articular surface of one bone fits into a complementary socket in the other. An important characteristic is that both articular surfaces are oval. Biaxial ellipsoidal joints allow all angular movements, that is, flexion and extension, abduction and adduction, as well as circumduction (circular motion). The wrist (wrist) joints and metacarpophalangeal joints are typical ellipsoidal joints.

Saddle joints

Carpometacarpal joint of the thumb

Biaxial joints are similar to ellipsoidal joints, but they allow greater freedom of movement. Each articular surface has both concave and convex sections, which is shaped like a saddle. The most suitable examples of saddle joints in the body are the carpometacarpal joints of the thumbs; You can see the movements allowed by these joints when you rotate your thumbs.

Ball and socket joints

Shoulder joint

Multi-axial connection. In ball and socket joints, the spherical or hemispherical head of one bone articulates with the cupped socket of another. These joints are multiaxial and the most mobile synovial joints. Any movement is possible in them (i.e. along all axes and planes, including rotation). Examples of ball and socket joints are the glenohumeral and hip joints.

Types of treatment for fluid accumulation in a joint

The accumulation of fluid in the joint can be treated in different ways, depending on the degree of advanced disease. Among the various joint treatment methods offered by the Kuntsevo Center, the following can be listed:

Drug treatment, which consists of prescribing and taking medications and vitamins.
One of the ways to treat joint diseases and relieve pain is blockade - special injections into the joint or periarticular tissue. This method of therapy is also used during the rehabilitation period after completion of treatment.
ACP SVF therapy is the latest unique method for treating degenerative joint diseases. To carry out this type of treatment, it is necessary to extract the stromal-vascular fraction from the patient, then prepare a special composition based on it and introduce it into the affected area of the joint by injection.

In each joint, basic elements and accessory formations are distinguished.

Movements can be carried out around one, two and three axes, forming one- (cylindrical and block-shaped), two- (ellipsoidal and saddle-shaped) and multi-axial (ball-and-socket) joints (Fig.

2). The number and position of axes determine the nature of the movements. There are movements around the frontal axis - flexion and extension, the sagittal axis - adduction and abduction, the longitudinal axis - rotation and multi-axis rotational movement.

1. Continuous

– synarthrosis – between the bones there is a layer that connects tissue. Motionless.

2. Semi-continuous

– hemiarthrosis (symphyses) – a small cavity with fluid

3. Intermittent

– diarthrosis (joints) of the bones are displaced relative to each other

All types of joints in the spinal column

Continuous connections : whether there is a gap or a cavity,

1. Fibrous compounds (syndesmoses) - ligaments (spreads from one bone to another), membranes - flat, wide, along the cord of bone - radius and ulna, hip joint - pelvic bone - obturator membrane - tibia and fibula; sutures - skulls - serrated suture, flat suture - facial bones, scaly suture - temporal region, impactions - attachment of teeth to the jaw; collagen - strength in the ligament, elastic fibers - mobility 2. Cartilaginous joints (synchodrosis) - permanent - sternum and 1 rib, intervertebral discs, temporary - pelvis - ischial, pubic, iliac, sacrum, places of attachment of the epiphysis and diaphysis 3. Bone joints ( synostosis) – replacement of temporary cartilaginous joints – fused sacrum

Intermittent connections

= joints.

mandatory and auxiliary elements. Mandatory: 1. The joint surfaces are in- and congruent, covered with hyaline cartilage - smoothes the bone tissue, as dense as the bone itself, it greatly facilitates movement in the joint. 2. The joint capsule is fibrous (protects the joint) and synovial membrane (rich in blood vessels, produces synovial fluid). 3. The articular cavity is a slit-like space between the articular surfaces and contains synovial fluid.

4. Synovial fluid - secreted by a membrane, with exfoliating cartilaginous and flat connective tissue cells form mucus, promotes adhesion, wetting, facilitating gliding

Semi-continuous = Half-joint – fibrous or cartilaginous joints. Symphysis pubis, manubrium sternum, intervertebral. There is no capsule, the inner surface of the fissure is not lined with synovial membrane. Can be strengthened by interosseous ligaments

10. Continuous bone connections.