Arthrology by Dr. Farrukh

ARTHROLOGY
Dr. M Farrukh Shahzad

BSPT, PPDPT
Isra University,
Islamabad Campus
IIRS DPT 1st Semester ( General Anatomy)
Topics of Discussion
Terminologies and definition
Functions
CLASSIFICATION
Classification on the basis of structure
Solid joints: 1.
Synovial joints.
CLASSIFICATION OF SYNOVIAL JOINTS
Classification according to complexity of shape
Classification according to axis of movement
Classification according to shape of articulating surfaces
Classification on the basis of function
Blood supply of joints

Nerve supply of joints
JOINT STABILITY
DEGENERATIVE JOINT DISEASES
Terminologies and
definition
Joint
[L. junctio a joining, connection]

The place of union or junction between two or more bones is
called joint.
Articulation
[L. articulatio place of junction between two discrete objects]
The place of union or junction between two or more bones.
Arthroses is also used for joint
The sight where two or more bones come together, whether or
not there is movement between them, is called a joint. The
structure and function of a joint are closely related.
The study of joints is called
arthrology.
This word is derived from the Greek world arthron.
The term joint does not always imply movement.
In the adult skull the bones forming joints are interlocked and so
united by bones of fibrous tissue that no movement is possible.
Different joints in body
(image)
Functions
To give mobility
To keep our body
segments together
CLASSIFICATION
There are different classification systems.
1.On the basis of structure
2. On the basis of function
3.On the basis of movement
1)Classification on the basis of

structure:
I.
II.
Solid joints: the joints without a cavity .

Synovial joints: the joints with a cavity
between them.
Continue.
Types of solid joints
10
Solid joints
1)
Fibrous joints:
the bones are held together by fibrous
connective tissue that is rich in
collagen fibers. No synovial cavity.
These are mostly seen between

the bones of skull.
Inferior tibiofibular joint is also an
example of fibrous joint. These are
united by fibrous tissue.
There is very little movement in
these joints. The degree of the
movement depends on the length
of the collagen fibers uniting the
bones.
11
Continue.
Fibrous joints are of three types.
1.
2.
3.
sutures
gomphoses
syndesmoses
12
Continue
1.Sutures
These are found only in skull. They are
found whenever margins or boarders

of bones are separated only by a type
of connective tissue.
During fetal life the flat bones of the
calvaria (the bones forming the roof of
skull) are separated from each other
by narrow seams of dense connective
tissue membranes that form fibrous
joints called sutures.
Sagittal suture is between two parietal
bones.
Coronal suture is between frontal and
parietal bones.
13
Continue
TYPES:
Serrate edges are sawlike
Denticulate: tooth like
processes
.
Squamous suture: bone
margins overlap
Plane suture:
apposition of flat surfaces
14
Continue
Gomphosis
These are peg and
socket joints. In this

type a peg fits into a
socket.
Examples are the
roots of the teeth
articulating with the
sockets in maxilla and
mandible
15
Continue.
Syndesmosis
In a syndesmosis the bones are
united by fibrous tissue forming

an interosseous membrane or
ligament.
Examples are
Inferior tibiofibular joints where
the bones are joined by
interosseous ligament. The
attachment of shafts of radius and
ulna is also by interosseous
membrane.
In a syndesmosis, movement is
possible due to the flexibility of
the interosseous ligament.
16
Continue
2.CARTILAGINOUS JOINTS
Here the articulating bones are united by a plate of cartilage.
Cartilaginous joints are of two types.
Primary cartilaginous joints. These are the joints where
articulating bones are united by a plate or bar hyaline
cartilage. Thus, the union between the epiphysis and the
diaphysis of a growing bone and that between the first rib
and manubrium sterni are examples of such type of joints.
No movement is possible.
Secondary cartilaginous joints. These are the joints
where bones are united by a plate of fibrocartilage, and the
articular surface of the bones are covered by a thin layer of
hyaline cartilage. Examples are the intervertebral (joints
between vertebral bodies) joints and the symphysis pubis.
The amount of movement depends on the physical quality of
the fibrocartilage.
17
Continue
Primary cartilaginous joints or
Synchondrosis
The union of bone and hyaline cartilage
forms this joint during the development
of bones (it is the joint between
epiphysis and diaphysis of long bones).
Since these are concerned with
development of bone, they disappear
once growth is complete and epiphysis
joins the diaphysis. This occurs by the
age of 25 or earlier.
All such joints are rigid and immobile
and hence very strong. The bones may
fracture but the bone-cartilage union
does not separate.
All epiphysis are examples of
synchondrosis.
The synchondrosis not obliterated during
life is between 1st rib and sternum.
18
Continue
Secondary cartilaginous joints or Symphysis
This type is found in the midline of the body and persists throughout
life. It is a union between two bones whose articular surface are

covered by hyaline cartilage and articulating bones are joined together
by a plate or disc of fibrocartilage. The fibrocartilage often contains a
cavity.
Examples are the joint between right and left pubic bones (symphysis
pubis) and intervertebral discs. The cavity of symphysis pubis contains
tissue fluid. The intervertebral disc contains gel in its cavity.
There is one joint in the body, which belongs to cartilaginous joints, but
is not typical of synchondrosis or symphysis. This is the joint between
manubrium and body of sternum. In the 4th month of intrauterine life
the sternum is formed of hyaline cartilage. Centers of ossification
appear in manubrium and the body. In the 1st instance, the manubriosternal joint is a synchondrosis. This hyaline cartilage becomes
fibrocartilage later on and hence its final form is that of a symphysis.
A limited amount of movement is possible at secondary cartilaginous
joints, depending on the amount of fibrous tissue within the
fibrocartilage.
19
Short Review
Terminologies and
definition
Functions
CLASSIFICATION
Classification on the basis
of structure
Solid joints: 1. Fibrous
joints:
Sutures
gomphoses
syndesmoses
CLASSIFICATION OF
SYNOVIAL JOINTS
Classification according to
complexity of shape
axis of movement
shape of articulating
surfaces
of function
2. CARTILAGINOUS JOINTS
Primary cartilaginous joints.

Secondary cartilaginous joints
Synovial joints.
20
SYNOVIAL JOINTS ( joints with a

cavity).
These joints are specialized to

perform free movements and
include all limb joints. They
show the following features.
The bone ends taking part are
covered with hyaline cartilage.
A capsule( fibrous connective
tissue) surrounds the joint.
The capsule encloses a cavity. It
is called synovial cavity. It
contains synovial fluid.
Sometimes the cavity is divided
into two by an articular disc.
The capsule is reinforced
internally and/or externally by
ligaments.
The capsule is lined internally
by synovial membrane.
The joint is moveable.
21
Continued
Internally synovial membrane lines the capsule
and is closely adherent to all surfaces in the

joint, which are non-articulating. It is attached
to the margins of articular surfaces. The cells of
this membrane secrete a viscous synovial fluid,
whose main function is lubrication.
Synovial fluid is a clear, slightly yellow fluid. Its
appearance and consistency resemble the white
of egg. Its amount is sufficient only to form a
thin film over all surfaces within joint cavity.
Even in a large joint such as knee, the amount is
about 0.5ml
22
Continued
When the capsule of a joint and the ligaments of a joint
are tightest, the joint is said to be in close packed such

as knee joint in full extension. In this condition the joint
surfaces makes maximum contact. A loose packed joint
(open packed) is one where the capsule and ligaments
become lose and relaxed.
Certain joints contain intra articular discs. They divide
the joint cavity into two independent cavities. Here the
articulating surfaces do not fit into each other properly
e.g. temporomandibular joints, sternoclavicular joints.
23
Accessory structures of synovial

jointsummery
Articular/Hyaline
Cartilage
Smooth cartilage at the end of bones at joint

Two-Layered
Joint Capsule
Outer Layer Tough fibrous capsule

Inner Layer Synovial Membrane
Synovial
Fluid
Slippery fluid in joint capsule

Ligament
A band of strong fibrous tissue

24
Accessory structures of synovial

jointcontinued
Articular/Hyaline Cartilage
Prevent friction between articulating bones
Two-Layered Joint Capsule
Outer Layer Strengthen joint
Inner Layer To secrete synovial fluid
Synovial Fluid
Reduce friction between articular cartilages
Nourish articular cartilage
Ligament
To connect one bone to another
25
Continued
Tendons
Strong connective tissue that attaches muscle to bone.
Connect muscle to muscle.
Bursa
Fluid filled sacs

Cushion the joint and act as shock absorbers
Meniscus
White fibrocartilage
Improves the congruency between bone ends
Increases joint stability
Reduces wear and tear at joint
26
SYNOVIAL JOINT
(image)
27
Types of synovial joints
(image)
28
CLASSIFICATION OF SYNOVIAL
JOINTS
Classifications systems
A.
classification according to complexity of shape
1.
Simple joints
Most synovial joints have two surfaces and are known as
simple joints. One surface of simple synovial joints is
convex (male) and the other.surface is concave (female).
2.
Compound joints
In a few joints the opposing surfaces are concavo-convex. The
larger of the two is considered male. If a joint has more then
two surfaces, it is known as compound e.g. the elbow joint.
3.
Complex joints
A joint containing an intra articular disc or a meniscus is known
as complex joint. The knee joint has more then two
articulating surfaces and also contains meniscus, therefore,
it is both complex and compound.
29
Continued
B . Classification according to axis of movement
1.
Uniaxial joints
In these joints movement is possible in only one axis.
Example is elbow joint. Here only flexion and extension is
possible.
2.
Biaxial joints
These show movements along two axes.
Example is metacarpophalangeal joints. Here one axis is
flexion and extension and other axis is abduction and
adduction.
3
Multiaxial or polyaxial joints
These can move along more than two axes.
Example is shoulder joint.
30
Continued.
C.
Third and very important

classification is based on according
to shape of articulating surfaces
1.
Plane joints
The opposing surfaces are flat or almost
flat. They allow gliding or sliding
movements. These joints are many and
are always small. They allow movements
in only one axis and are hence uniaxial
joints.
Examples are intercarpal joints (the joints
between carpal bones), acromioclavicular
joints. These joints have tight articular
ligaments, and as a result, the movement
is limited.
Intertarsal and sternoclavicular,
costovertebral, cost transverse joints
31
Examples of plane joint

(image)
32
Types of synovial joints

continued
2
Hinge joints
These joints resemble the
hinge on a door. The shape
of opposing surfaces allows
movements in one plane i.e.
they are uniaxial joints.
They allow only flexion and
extension. The bones are
joined by strong collateral
ligaments, which are
laterally placed. The joint
capsule is thin and lax
anteriorly.
Examples are elbow joint,
knee joint, ankle joint and
interphalangeal joints.
33
Continued
3 Pivot joints
These are uniaxial joints.
The movement
occurring is rotation. In
these joints rounded
process of a bone (pivot)
rotates within a ring
made of bone and
ligaments.
Examples are superior
radioulnar joints and
median atlantoaxial joint.
34
Continued
4 Condyloid Joints.
The convex ovalshaped projection

of one bone fits
into the ovalshaped depression
of another bone
e.g.
metacarpophalang
eal joints.
35
Continued
5. Saddle Joints
here the articular
surface of one bone
is saddle-shaped and
the articular surface
of the other fits into
the saddle.
e.g.
Carpometacarpal
joint.
36
Continued
6. Ball and socket joints
(spheroidal joints)
The rounded surface of one
bone (ball) moves within the
socket of another bone. These
are multiaxial joints. The
movements taking place are
flexion extension, abduction
adduction, lateral and
medial rotation, and
circumduction.
Examples are hip joint and
shoulder joint. In cases of hip
joint the head of the femur
moves in acetabulum of
hipbone. In shoulder joint the
head of humerus articulate
with glenoid cavity of scapula.
37
Continued
7. Ellipsoid joints
In these types of joints one articulating
surface is oval and convex, whereas the other
surface is elliptical and concave. These are
biaxial joints. The movements possible are
flexionextension, abduction-adduction, with
circumduction in some cases but rotation is
impossible.
Examples is radiocarpal (wrist) joint.
38
2.Classification on the basis of

function.
Synarthrosis:
an immovable joint.
primary cartilaginous
joints are synarthrosis.
Amphiarthrosis:
a slightly movable joint.

Most amphiarthrosis
joints are secondary
cartilaginous.
Diarthrosis:
a freely movable joint. All

diarthroses are synovial
joints.
39
Factors affecting ROM at

Synovial Joints
Structure or shape of
the articulating bones

Strength and tension
of ligaments.
Arrangement and
tension of muscles
Apposition of soft
parts
Hormones
use
40
Short Review

Functions
CLASSIFICATION
Classification on the basis of
structure
Solid joints: 1. Fibrous joints:
Synovial joints.
JOINTS
complexity of shape
Simple joints
Compound joints
Complex joints
Uniaxial joints
Biaxial joints
shape of articulating
surfaces
Plane joints
Hinge joints
Pivot joints
Condyloid Joints
Saddle Joints
Ball and socket joints
Ellipsoid joints
of function

axis of movement
Sutures
gomphoses
syndesmoses
Synarthrosis:
Amphiarthrosis:
Diarthrosis:
41

Articular arteries from
vessels around joints

Often these arteries
form anastamoses
around joints
Articular veins
accompany arteries
Articular veins like
articular arteries, are
located inside a joint
capsule, mostly in the
synovial membranes
42

The capsule and ligaments
receive an abundant sensory

nerve supply. That is why the
joint injuries are very painful.
Twisting and stretching of joint
ligaments is common in sports
such as football, basketball.
The synovial membrane is
relatively insensitive. The
nerves here are of vasomotor
nature (i.e. they act on the
blood vessels and increase or
decrease the blood supply).
The blood vessels receive
autonomic sympathetic fibers.
The cartilage covering the
articular surfaces has only a
few nerve endings near its
edges.
43
Continued.
The nerves are mostly branches of nerves that cross the
joints and move it. The branches of the nerves supplying the
skin over the joint also supply the joints. This correlation is
expressed in Hiltons law, which states.
A nerve supplying a joint also supplies the muscles moving
the joint and the skin over the insertions of these muscles.
The same trunks of nerves, whose branches supply the
groups of muscles moving the joint, furnish also a
distribution of nerves to the skin over the insertions of the
same muscles; and the interior of the joint receives its
nerves from the same source.
Overstretching of the capsule and ligaments produces reflex
contraction of muscles around the joint.
Nerves supplying a joint carry information that provides
awareness of movements and position of parts of the body.
This sensation is known as proprioception.
44
JOINT STABILITY
The stability of a joint depends on three main factors.
1.
The shape, size, and arrangement of the aricular

surfaces
2.
The ligaments in and around the joint
3.
The tone of the muscles around the joint

45

Risk factors include age ,heredity,
injury and obesity

Particularly those of hip, knee,
vertebral column and hands
Some destruction takes place
during such activities as jogging,
which wears away the articular
cartilages and sometimes erodes
the underlying articular surfaces
Trauma to a joint may be followed
by arthritis ,(inflammation of joint)
and septicemia (systemic
infection)
46
Continued
Most common is
osteoarthritis,
which is often
accompanied by
stiffness, discomfort
and pain.
47
Continued..
Rheumatoid
arthritis
Chronic inflammatory
disorder
Autoimmune disease.
48
Comparison OA/RA
49
Short Review

Functions
axis of movement
CLASSIFICATION
structure
Solid joints: 1. Fibrous joints:
shape of articulating surfaces
Sutures
gomphoses
syndesmoses

Synovial joints.
JOINTS
complexity of shape
Simple joints
Compound joints
Complex joints
Uniaxial joints
Biaxial joints
Plane joints
Hinge joints
Pivot joints
Condyloid Joints
Saddle Joints
Ball and socket joints
Ellipsoid joints
function
Synarthrosis:
Amphiarthrosis:
Diarthrosis:

JOINT STABILITY
50
Best
wishes..!
thanks!
51

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ARTHROLOGY

Dr. M Farrukh Shahzad

IIRS DPT 1st Semester ( General Anatomy)

Blood supply of joints

[L. junctio a joining, connection]

Different joints in body

IIRS DPT 1st Semester ( General Anatomy)

IIRS DPT 1st Semester ( General Anatomy)

IIRS DPT 1st Semester ( General Anatomy)

1)Classification on the basis of

Solid joints: the joints without a cavity .

IIRS DPT 1st Semester ( General Anatomy)

IIRS DPT 1st Semester ( General Anatomy)

Types of solid joints

IIRS DPT 1st Semester ( General Anatomy)

These are mostly seen between

IIRS DPT 1st Semester ( General Anatomy)

IIRS DPT 1st Semester ( General Anatomy)

found whenever margins or boarders

IIRS DPT 1st Semester ( General Anatomy)

IIRS DPT 1st Semester ( General Anatomy)

socket joints. In this

united by fibrous tissue forming

IIRS DPT 1st Semester ( General Anatomy)

IIRS DPT 1st Semester ( General Anatomy)

life. It is a union between two bones whose articular surface are

Primary cartilaginous joints.

SYNOVIAL JOINTS ( joints with a

These joints are specialized to

IIRS DPT 1st Semester ( General Anatomy)

and is closely adherent to all surfaces in the

are tightest, the joint is said to be in close packed such

IIRS DPT 1st Semester ( General Anatomy)

Accessory structures of synovial

Smooth cartilage at the end of bones at joint

Outer Layer Tough fibrous capsule

Slippery fluid in joint capsule

A band of strong fibrous tissue

Accessory structures of synovial

IIRS DPT 1st Semester ( General Anatomy)

Fluid filled sacs

IIRS DPT 1st Semester ( General Anatomy)

Types of synovial joints

IIRS DPT 1st Semester ( General Anatomy)

IIRS DPT 1st Semester ( General Anatomy)

Third and very important

IIRS DPT 1st Semester ( General Anatomy)

Examples of plane joint

IIRS DPT 1st Semester ( General Anatomy)

Types of synovial joints

IIRS DPT 1st Semester ( General Anatomy)

IIRS DPT 1st Semester ( General Anatomy)

The convex ovalshaped projection

IIRS DPT 1st Semester ( General Anatomy)

IIRS DPT 1st Semester ( General Anatomy)

IIRS DPT 1st Semester ( General Anatomy)

2.Classification on the basis of

a slightly movable joint.

a freely movable joint. All

IIRS DPT 1st Semester ( General Anatomy)

Factors affecting ROM at

the articulating bones

Terminologies and definition

Classification on the basis of