Humeroradial Joint
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The humeroradial joint is the
joint 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.Saladin, Ken. Anatomy & Physiology. 7th ed. McGraw- ...
between the head of the
radius In classical geometry, a radius (: radii or radiuses) of a circle or sphere is any of the line segments from its Centre (geometry), center to its perimeter, and in more modern usage, it is also their length. The radius of a regular polygon is th ...
and the capitulum of the
humerus The humerus (; : humeri) is a long bone in the arm that runs from the shoulder to the elbow. It connects the scapula and the two bones of the lower arm, the radius (bone), radius and ulna, and consists of three sections. The humeral upper extrem ...
, is a limited
ball-and-socket joint The ball-and-socket joint (or spheroid joint) is a type of synovial joint in which the ball-shaped surface of one rounded bone fits into the cup-like depression of another bone. The distal bone is capable of motion around an indefinite number of ...
, hinge type of
synovial joint 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' articulati ...
.


Structure

The annular ligament binds the head of the radius to the
radial notch The radial notch of the ulna (lesser sigmoid cavity) is a narrow, oblong, articular depression on the lateral side of the coronoid process; it receives the circumferential articular surface of the head of the radius. It is concave from before b ...
of the
ulna The ulna or ulnar bone (: ulnae or ulnas) is a long bone in the forearm stretching from the elbow to the wrist. It is on the same side of the forearm as the little finger, running parallel to the Radius (bone), radius, the forearm's other long ...
, preventing any separation of the two bones laterally. Therefore, the humeroradial joint is not functionally a
ball and socket joint The ball-and-socket joint (or spheroid joint) is a type of synovial joint in which the ball-shaped surface of one rounded bone fits into the cup-like depression of another bone. The distal bone is capable of motion around an indefinite number of ...
, although the joint surface in itself allows movement in all directions. The annular ligament secures the head of the radius from
dislocation In materials science, a dislocation or Taylor's dislocation is a linear crystallographic defect or irregularity within a crystal structure that contains an abrupt change in the arrangement of atoms. The movement of dislocations allow atoms to sli ...
, which would otherwise tend to occur, from the shallowness of the cup-like surface on the head of the radius. Without this ligament, the
tendon A tendon or sinew is a tough band of fibrous connective tissue, dense fibrous connective tissue that connects skeletal muscle, muscle to bone. It sends the mechanical forces of muscle contraction to the skeletal system, while withstanding tensi ...
of the
biceps brachii The biceps or biceps brachii (, "two-headed muscle of the arm") is a large muscle that lies on the front of the upper arm between the shoulder and the elbow. Both heads of the muscle arise on the scapula and join to form a single muscle bell ...
would be liable to pull the head of the radius out of the joint. The head of the radius is not in complete contact with the capitulum of the humerus in all positions of the joint. The capitulum occupies only the
anterior Standard anatomical terms of location are used to describe unambiguously the anatomy of humans and other animals. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position pro ...
and inferior surfaces of the lower end of the humerus, so that in complete extension a part of the radial head can be plainly felt projecting at the back of the joint. In full
flexion Motion, the process of movement, is described using specific anatomical terminology, anatomical terms. Motion includes movement of Organ (anatomy), organs, joints, Limb (anatomy), limbs, and specific sections of the body. The terminology used de ...
the movement of the radial head is hampered by the compression of the surrounding soft parts, so that the freest rotatory movement of the radius on the humerus (
pronation Motion, the process of movement, is described using specific anatomical terminology, anatomical terms. Motion includes movement of Organ (anatomy), organs, joints, Limb (anatomy), limbs, and specific sections of the body. The terminology used de ...
and
supination Motion, the process of movement, is described using specific anatomical terms. Motion includes movement of organs, joints, limbs, and specific sections of the body. The terminology used describes this motion according to its direction relativ ...
) takes place in semiflexion, in which position the two articular surfaces are in most intimate contact. Flexion and extension of the elbow-joint are limited by the tension of the structures on the front and back of the joint; the limitation of flexion is also aided by the soft structures of the arm and forearm coming into contact.


Clinical significance


Subluxation

A subluxation of the humeroradial joint is called a " nursemaid's elbow", also known as ''radial head subluxation''. It is generally caused by a sudden pull on the extended pronated forearm, such as by an adult tugging on an uncooperative child or by swinging the child by the arms during play. In radial head
subluxation A subluxation is an incomplete or partial dislocation of a joint or organ. According to the World Health Organization, a subluxation is a "significant structural displacement" and is therefore visible on static imaging studies, such as X-rays. ...
, there is little complaint of pain, and the person generally reports pain in the proximal
forearm The forearm is the region of the upper limb between the elbow and the wrist. The term forearm is used in anatomy to distinguish it from the arm, a word which is used to describe the entire appendage of the upper limb, but which in anatomy, techn ...
. The mechanism is slippage of the head of the radius under the annular ligament. The distal attachment of the annular ligament covering the radial head is weaker in children than in adults, allowing it to be more easily torn. The older child will usually point to the dorsal aspect of the proximal forearm when asked where it hurts. This may mislead one to suspect a buckle fracture of the proximal radius. There is no tear in the soft tissue (probably due to the pliability of young connective tissues).


Dislocation

A ''radial head dislocation'' is mainly caused by trauma, or by a congenital state. The traumatic form is usually seen in infancy and childhood as an isolated injury. File:Radiocapitellar line - normal.jpg, The ''radiocapitellar line'' is used in the detection of radial head dislocation on lateral
X-rays An X-ray (also known in many languages as Röntgen radiation) is a form of high-energy electromagnetic radiation with a wavelength shorter than those of ultraviolet rays and longer than those of gamma rays. Roughly, X-rays have a wavelength ran ...
. It normally goes through the
capitulum of the humerus In human anatomy of the arm, the capitulum of the humerus is a smooth, rounded eminence on the lateral portion of the distal articular surface of the humerus. It articulates with the cup-shaped depression on the head of the radius, and is limi ...
. File:Radiocapitellar line - abnormal.jpg, Abnormally pointed radiocapitellar line, indicating radial head dislocation.


Additional images

file:Gray331.png, Capsule of elbow-joint (distended) seen from front file:Gray332.png, Capsule of elbow-joint (distended) seen from back file:Gray329.png, Left elbow-joint showing anterior and ulnar collateral ligaments file:Gray330.png, Left elbow-joint showing posterior and radial collateral ligaments


See also

*
Elbow The elbow is the region between the upper arm and the forearm that surrounds the elbow joint. The elbow includes prominent landmarks such as the olecranon, the cubital fossa (also called the chelidon, or the elbow pit), and the lateral and t ...
* Humeroulnar joint


References


External links

* - "Joints of the Upper Extremity: Elbow joint" {{Authority control Joints Upper limb anatomy