The META Scholar Volume 7 | Page 37

They are classified by structure and function, where the structural classification is concerned with bonebinding materials, and if a joint cavity is present. The three joint types mentioned already, is an example of structural classification. The movement of a joint is the basis of functional classification; which are synarthroses (immovable), amphiarthroses (slightly movable), and diarthroses (freely movable). The functional classification (diarthroses) is the classification synovial joints fall under, which is almost all the joints of the limbs—basically the majority of articulations in the body. Fibrous joints are termed as such, because there articulations are united by fibrous tissue, and cartilaginous joints are binned by hyaline cartilage or fibrocartilage respectively. Now onto the focus of our understanding, synovial joints are characterized by a fluid-filled cavity separating the articulating bones. This synovial fluid serves two functions, as a lubricant for joint surfaces and to nourish the articular cartilage. (Keith, M. L. & others, 2015). “Synovial joints are usually reinforced by accessory ligaments that either are separate (extrinsic) or are a thickened part of the joint capsule (intrinsic). Some synovial joints have other distinguishing features, such as cartilaginous articular discs or menisci, which are present when the articulating surfaces of the bones are incongruous.” Synovial joints come in six varieties, which are pivot, ball and socket, plane, hinge, saddle, and condyloid. They all have varying degrees of movement, but this is a general interpretation. These joint designs are what influence the diarthroses (freely movements) characterized by synovial joint. Let’s consider the general structure of a synovial joint as expressed in the figure titled “General structure of a synovial joint.” There are six distinguishing features that are identifiable in synovial joints. They include articular cartilage, joint (articular) cavity, nerves and blood vessels, articular capsule, synovial fluid, and reinforcing ligaments. I will start with articulating cartilage and work my way to nerves and blood vessels. Articular cartilage is a type of hyaline cartilage and has a smooth glass like appearance. They are very thin (1mm or less) spongy cushions, which function to absorb the forces or compression applied to the joint. This in turn keeps the ends of the bones from crushing together. The joint (articular) capsule is a synovial specific feature, just a potential space containing fluid (synovial fluid). This synovial fluid as mentioned earlier plays a big role in rheumatoid arthritis. It is the first structure effected and lends itself indirectly to the perpetuation of joint damage, for without this lubricant, rubbing begins to wear away joint surfaces. Which produces exorbitant friction and destroys the joint tissues, literally cooking them! Not to go into too much detail the reinforcing ligaments are as the name suggest reinforcing ligaments. They commonly are capsular ligaments (thickened parts of the fibrous layer), and come in two varieties, extracapsular (outside the capsule) and intracapsular (deep to it). Although not represented in the figures; innervating the capsule are richly supplied sensory nerve fibers, which often detects pain sensation. As most anybody who has experienced joint inflammation or injury knows. Also richly supplying synovial joints are blood vessels. This is an important thing to understand, because mostly supplying the synovial membrane are these capillary beds, which are the factories that produce blood filtrate, forming the basis of synovial fluid. This synovial fluid largely being derived from the blood filtrate. Might this be a site of concern in clinical diagnoses of rheumatoid arthritis? This leads us into the medical device(s) used in diagnosing RA, and the normal operation of such devices.