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A synovial joint, also known as diarthrosis, joins 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. They are the most common and most movable type of joint in the body of a mammal. As with most other joints, synovial joints achieve movement at the point of contact of the articulating
bone A bone is a rigid organ that constitutes part of the skeleton in most vertebrate animals. Bones protect the various other organs of the body, produce red and white blood cells, store minerals, provide structure and support for the body, ...
s.


Structure

Synovial joints contain the following structures: * Synovial cavity: all diarthroses have the characteristic space between the bones that is filled with synovial fluid * Joint capsule: the fibrous capsule, continuous with the periosteum of articulating bones, surrounds the diarthrosis and unites the articulating bones; the joint capsule consists of two layers - (1) the outer
fibrous Fiber or fibre (from la, fibra, links=no) is a natural or artificial substance that is significantly longer than it is wide. Fibers are often used in the manufacture of other materials. The strongest engineering materials often incorporat ...
membrane that may contain ligaments and (2) the inner synovial membrane that secretes the lubricating, shock absorbing, and joint-nourishing synovial fluid; the joint capsule is highly innervated, but without blood and lymph vessels, and receives nutrition from the surrounding blood supply via either diffusion (a slow process) or by
convection Convection is single or multiphase fluid flow that occurs spontaneously due to the combined effects of material property heterogeneity and body forces on a fluid, most commonly density and gravity (see buoyancy). When the cause of the c ...
, a far more efficient process achieved through exercise. * Articular cartilage: the bones of a synovial joint are covered by this layer of
hyaline cartilage 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 h ...
that lines the epiphyses of joint end of bone with a smooth, slippery surface that does not bind them together; articular cartilage functions to absorb shock and reduce friction during movement. Many, but not all, synovial joints also contain additional structures: * Articular discs or menisci - the fibrocartilage pads between opposing surfaces in a joint * Articular fat pads - adipose tissue pads that protect the articular cartilage, as seen in the infrapatellar fat pad in the knee * Tendons - cords of dense regular connective tissue composed of parallel bundles of
collagen fibers Type I collagen is the most abundant collagen of the human body. It forms large, eosinophilic fibers known as collagen fibers. It is present in scar tissue, the end product when tissue heals by repair, as well as tendons, ligaments, the endomy ...
* Accessory ligaments (extracapsular and intracapsular) - the fibers of some fibrous membranes are arranged in parallel bundles of dense regular connective tissue that are highly adapted for resisting strains to prevent extreme movements that may damage the articulation * Bursae - saclike structures that are situated strategically to alleviate friction in some joints (shoulder and knee) that are filled with fluid that is similar to synovial fluid The bone surrounding the joint on the proximal side is sometimes called the ''plafond'', especially in the talocrural joint. A damage to this occurs in a Gosselin fracture.


Blood supply

The blood supply of a synovial joint is derived from the arteries sharing in the anastomosis around the joint.


Types

There are seven types of synovial joints. Some are relatively immobile, but are more stable. Others have multiple degrees of freedom, but at the expense of greater risk of injury. In ascending order of mobility, they are:


Function

The movements possible with synovial joints are: *
abduction Abduction may refer to: Media Film and television * "Abduction" (''The Outer Limits''), a 2001 television episode * " Abduction" (''Death Note'') a Japanese animation television series * " Abductions" (''Totally Spies!''), a 2002 episode of an ...
: movement away from the mid-line of the body * adduction: movement toward the mid-line of the body *
extension Extension, extend or extended may refer to: Mathematics Logic or set theory * Axiom of extensionality * Extensible cardinal * Extension (model theory) * Extension (predicate logic), the set of tuples of values that satisfy the predicate * Ext ...
: straightening limbs at a joint * flexion: bending the limbs at a joint * rotation: a circular movement around a fixed point


Clinical significance

The ''joint space'' equals the distance between the involved bones of the joint. A ''joint space narrowing'' is a sign of either (or both)
osteoarthritis Osteoarthritis (OA) is a type of degenerative joint disease that results from breakdown of joint cartilage and underlying bone which affects 1 in 7 adults in the United States. It is believed to be the fourth leading cause of disability in the ...
and inflammatory degeneration. The normal joint space is at least 2 mm in the hip (at the superior
acetabulum The acetabulum (), also called the cotyloid cavity, is a concave surface of the pelvis. The head of the femur meets with the pelvis at the acetabulum, forming the hip joint. Structure There are three bones of the ''os coxae'' (hip bone) that c ...
), at least 3 mm in the knee, and 4–5 mm in the shoulder joint., in turn citing: For the temporomandibular joint, a joint space of between 1.5 and 4 mm is regarded as normal. Joint space narrowing is therefore a component of several
radiographic classifications of osteoarthritis Radiographic systems to classify osteoarthritis vary by which joint is being investigated. In osteoarthritis, the choice of treatment is based on pain and decreased function, but radiography can be useful before surgery in order to prepare for th ...
. In
rheumatoid arthritis Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and hands are inv ...
, the clinical manifestations are primarily synovial inflammation and joint damage. The fibroblast-like synoviocytes, highly specialized mesenchymal cells found in the synovial membrane, have an active and prominent role in the pathogenic processes in the rheumatic joints. Therapies that target these cells are emerging as promising therapeutic tools, raising hope for future applications in rheumatoid arthritis.


References

Tortora & Derrickson () ''Principles of Anatomy & Physiology'' (12th ed.). Wiley & Sons Rogers, Kara (2010) ''Bone and Muscle: Structure, Force, and Motion'
p.157
/ref> Sharkey, John (2008) ''The Concise Book of Neuromuscular Therapy'
p.33
/ref> Moini (2011) ''Introduction to Pathology for the Physical Therapist Assistant'
pp.231-2
/ref> Bruce Abernethy (2005) ''The Biophysical Foundations Of Human Movement'' pp.23
331
/ref>
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