A joint is the
contact area between the bones, a bone and cartilage, or between tissue
bone and teeth.
classification
According to its
constitution, are classified as:
1 - Strings: with
fibrous tissue (with abundant collagen fibers) and no joint cavity.
2 - cartilage: bone
union is by cartilage, and have no joint cavity.
3 - Synovial: the
bones are kept together by the action of dense connective tissue
a joint capsule and
ligaments work, have joint capsule.
According to
their function, are classified as:
1 - sinartrosis: they
are still
2 - amphiarthrosis:
with limited movement
3 - diarthrosis: with
a variety of movements
fibrous joints
No joint cavity,
bones held together by fibrous connective tissue. They have no mobility. Their
types are:
1 - Sutures: are the
joints of the bones of the skull, with irregular borders and intertwined.
Includes synostosis
or bone joints in which there is complete fusion of the bone
in the connection
line (eg the front suture). Are functionally sinartrosis.
2 - syndesmosis: the
amount of fibrous connective tissue is higher than the previous one, and is
arranged as a sheet
between the two bones. For example tibiofibular joint
distally. Are
functionally amphiarthrosis.
gomphosis: the
articulation of the roots of the teeth in the jawbone. Are functionally sinartrosis
cartilaginous joints
They have no joint
cavity, bones, remains united by fibrocartilage or hyaline cartilage. Their
types are:
1 - synchondrosis:
the connecting material is hyaline cartilage. For example, the articulation of
the first rib and the manubrium of the sternum in children. (later ossifies and
becomes synostosis). Are functionally sinartrosis.
2 - Symphysis: bones
have a layer of hyaline cartilage and bone between a disc of fibrocartilage.
For example the symphysis pubis and intervertebral joints. Are functionally
amphiarthrosis.
synovial joints
Its structure
comprises:
1) synovial cavity
2) articular
cartilage
3) Joint capsule has
an outer layer or fibrous capsule and inner synovial membrane, sometimes may be
accumulations of fatty tissue called articular fat pads.
4) synovial fluid
5) intracapsular and
extracapsular ligaments accessories.
6) joint discs or
menisci.
Different types of
joints.
The types of synovial
joints are:
1 - Flat: allow sliding
movement in one plane, for example sternocostal or vertebrocostal.
2 - hinge: move in a
plane about a single axis, allow only flexion and extension, eg knee, elbow,
ankle. 3 - Pivot: are uniaxial and facilitate the rotation, for example the
articulation of the atlas with the
axis.
4 - saddle: they are
biaxial and faces are concave and convex, eg carpal-metacarpal joint of the
thumb.
5 - Spherical: are
multiaxial, and very mobile, a spherical surface moves into a cavity, eg the
femoral head in the acetabulum of the iliac bone.
6 - condylar: are
biaxial and allow movement in the sagittal and coronal, eg metacarpophalangeal
joints or knuckles.
Functionally all
synovial joints are synovial joints.
Disorders
Temporomandibular
joint pain episodes may occur from three sources: collateral ligaments,
retrodiscal tissue, joint capsule, all these structures are densely innervated
by making it easy to understand the origin of pain.
Factors that increase
the risk of developing temporomandibular disorders which call, predisposing
factors, and in turn there are others that trigger the onset of pain to which
we will call Trigger Factors. Many times the patient functions in equilibrium
with predisposing factors and no pain because the balance between the
musculoskeletal elements esquletales prevent it. It has even been demonstrated
in patients with bone remodeling to accommodate excessive loads on the joint
system to protect the patient from the beginning of a painful process.
The most common
presenting symptoms are localized pain in the preauricular area or the chewing
muscles that is aggravated by chewing, there is often limited or asymmetric jaw
movement, can occur clicks, clicking, or crepitus depending on the conditions
present in clinical entity intra-articular origin
Definition Muscle
Disorders Clinic of the most common:
Co-contraction
Protection: a response induced by central nervous system to protect the muscle
where muscle damage or suspected. There is an increased muscle tone response
secondary to a central system.
Located Muscle
Soreness: a primary muscle noninflammatory condition, which comes after a
muscle injury or a Co-Contraction Protection.
Myofascial pain: a
regional pain, from mild intensity, presence of tender points (trigger points),
to anesthetize the pain these pain points not continuous (3), it is important
to understand the concept of referred pain to treat these patients, since
generally the source of pain and the point of pain does not match. It is
believed that localized ischemia can cause a sensitivity of the trigger point.
Clinical Definition
of the most common joint disorder:
Disk Displacement:
the condition is most common intra-articular, and has a clinical course of
stages in which you can see a progression of arthropathy, there is an abnormal
disc-condyle complex, usually seen anterior displacement and medial articular
disc
Disc displacement
with reduction: as seen from the closed mouth position, the disc transiently
misaligned "reduce" the wrong position on the condyle, the mandibular
translation occur during mouth opening. The patient has a noise in closing and
opening one formerly described as "reciprocal click" which is a
classic clinical sign of this condition.
It may be painful to
the patient the phenomenon of "hard reduction", which is a sign
present in some cases
Disc displacement
without reduction: a disc-condyle relationship that lasts altered the
translation, the disc is permanently displaced and "reduce." In its
acute stage is painful and the patient has marked limitation in mandibular
movement, opening is observed in a deviation from the midline toward the
affected side, and a limited laterotrusion to the opposite side.
Arthritis
Is inflammation of one or more joints. A joint is the
area where two bones meet. There are over 100 different types of arthritis.
.
causes
Arthritis involves the breakdown of cartilage, which
normally protects a joint, allowing it to move smoothly. Cartilage also absorbs
shock when pressure is exerted on the joint, like when you walk. Without the
usual amount of cartilage, bones rub together, causing pain, swelling
(inflammation) and stiffness.
The joint inflammation can result from:
An autoimmune disease (the body's immune system
mistakenly attacks healthy tissue).
Bone fracture.
"Wear and tear" on joints.
Infection, usually by bacteria or viruses.
Usually, joint inflammation disappears after the cause
is removed or treated. Sometimes it does not. When this happens, you have
chronic arthritis. Arthritis can occur in men and women. Osteoarthritis is the
most common type.
Other common types of arthritis include:
ankylosing spondylitis
gonococcal arthritis
drop
Juvenile rheumatoid arthritis (in children)
Other bacterial infections (nongonococcal bacterial
arthritis)
psoriatic arthritis
Reactive arthritis (Reiter's syndrome)
Rheumatoid arthritis (in adults)
scleroderma
Lupus erythematosus (SLE)
symptoms
Arthritis causes pain, swelling, stiffness and limited
movement in the joint. Symptoms may include:
Joint pain.
Joint inflammation.
Decreased ability to move the joint.
Redness of skin around a joint.
Rigidity, especially in the morning.
Warmth around a joint.
Exams and Tests
The doctor will perform a physical exam and ask
questions about your medical history.
Physical examination may show:
Fluid around a joint.
Hot, red and tender.
Difficulty moving a joint (called "limited range
of motion").
Some types of arthritis can cause joint deformity,
which may be a sign of severe rheumatoid arthritis that has not been addressed.
Often do blood tests and joint x-rays to check for
infection and other causes of arthritis.
The doctor may also remove a sample of joint fluid
with a needle and sent to a lab for analysis.
treatment
The goal of treatment is to reduce pain, improve
function and prevent joint damage more. Usually you can not cure the underlying
cause.
Osteoarthritis
Osteoarthritis is a disease of the joints that mostly
affects cartilage. Cartilage is the slippery tissue that covers the ends of
bones in a joint. The cartilage allows bones to glide over each other. It also
absorbs shock that occur with physical movement. With osteoarthritis, the top
layer of cartilage breaks down and wears away. As a result, bones that were
previously covered by cartilage begin to rub. The rubbing causes pain, swelling
and loss of motion in the joint. Over time, the joint may lose its normal
shape. Further, spurs may grow around the joint. Bits of bone or cartilage can
break off and float inside the space that exists in the joint which causes more
pain and damage.
People with osteoarthritis often have joint pain and
limitation of motion. Unlike other forms of arthritis, osteoarthritis affects
only joints and not internal organs. Rheumatoid arthritis, which is the second
most common type of arthritis affects the joints and other body parts.
Osteoarthritis is the most common type of arthritis.
Osteoarthritis often occurs in the elderly. Some young
people sometimes have osteoarthritis primarily by joint injuries.
Osteoarthritis usually occurs gradually over time. It
can be caused by the following factors:
overweight
aging
Lesions of the joints
Defects in the formation of joint
A genetic defect in joint cartilage
The fatigue of the joints from certain jobs and
sports.
Doctors often combine treatments to suit the needs,
lifestyle and health of the patient. Treatment of osteoarthritis has four main
objectives:
Improve joint function
Maintaining a healthy weight
Control pain
Achieving a healthy lifestyle.
The treatment plan for osteoarthritis may include:
exercise
Weight control
Rest and joint care
Techniques to control pain without medication
drugs
Complementary and Alternative Therapies
Surgery.
Osteoarthritis can occur in any joint. It occurs most
often in the hands, knees, hips and spine.
The warning signs of osteoarthritis include:
Stiffness in a joint after getting out of bed or after
sitting for a long time
Swelling or tenderness in one or more joints
Feeling or the crunch of bones rubbing against each
other.
There is no specific test to diagnose osteoarthritis.
Most doctors use several methods to diagnose the disease and rule out other
problems such as:
medical History
physical examination
radiographs
Other tests such as blood tests or examination
of joint fluid
Rheumatism
Rheumatism or Rheumatic disorder is a nonspecific term
for medical problems affecting the joints, heart, bones, kidneys, skin and
lungs.
The major rheumatic disorders currently recognized include:
ankylosing spondylitis
Back pain
Bursitis / tendonitis (shoulder pain, wrist, biceps,
legs, knee, ankle, heel and hip).
capsulitis
Neck pain
osteoarthritis
psoriatic arthritis
rheumatic fever
Rheumatic fever (a long-term complication of rheumatic
fever)
rheumatoid arthritis
lupus erythematosus
Giant cell arteritis and Polymyalgia rheumatica
tenosynovitis
myositis
initial treatment in rheumatic diseases is more
important with analgesics such as paracetamol and anti-inflammatory drugs
(NSAIDs), which are ibuprofen and naproxen. Often, stronger analgesics are
required
hip dysplasia
We can define hip dysplasia in clinical development as
a starting variable, is the anatomical alteration of the hip joint in newborns,
where the femoral head remains outside the
acetabulum at birth or is unstable (may dislocate) in
the first weeks of life. This causes the femoral head and acetabulum not develop normally.
