A joint is the part of the body where two or more bones meet to allow movement. Generally speaking, the greater the range of movement, the higher the risk of injury because the strength of the joint is reduced. The six types of freely movable joint include ball and socket, saddle, hinge, condyloid, pivot and gliding.

1. JOINTS
PRESENTED BY: Ms.Sapna
ASSISTANT PROFESSOR
PHARMACOLOGY
MMCP, MM(DU)

2. Introduction of Joints
Joint is a junction between two
or more bones or cartilages. It is
a device to permit movement.
With the exception of the
hyoid bone, every bone in the
body is connected to or forms
a joint.
There are 230 joints in the body

3. Functions of Joint
Hold the skeletal bones together.
Allow the skeleton some flexibility so gross movement
can occur.
Make bone growth possible.

4. Classification of Joints
Joint are classified into structural and functional.
Structural classification is determined by how the
bones connect to each other, while functional
classification is determined by the degree of
movement between the articulating bones.

5. Structural Classification of Joints
 Fibrous
(Fixed)
A.Sutures
1. Plane
2. Squamous
3. Serrate
4. Dentate
5. Schindylesis
B. Gomphosis
C. Syndesmosis
Cartilaginous
(Slightly movable)
A. Primary
Cartilaginous joints
(Synchondrosis)
B. Secondary
Cartilaginous joints
(Symphysis)
 Synovial Freely
(movable)
1. Plane
2. Hinge
3. Pivot
4. Bicondylar
5. Ellipsoid
6. Saddle
7. Ball and socket

6. Structural classification cont…
Fibrous Joints:- Bones are joined by fibrous
tissue/dense connective tissue, consisting mainly of
collagen. The fibrous joints are further divided into
three types:-
1. Sutures or synostoses :- Found between bones of
the skull. In fetal skulls the sutures are wide to allow
slight movement during birth. They later become
rigid.

7. Types of Sutures..
(lambdoid suture)

8. 2. Syndesmoses are joints where two
adjacent bones are join together by a
greater amount of connective tissue
than in sutures in the form of
interosseous ligaments and
membranes.
Eg-interosseous radioulanr
joint,interosseous tibiofibular
joint.

9. 3. Gomphoses :- It is a specialized
fibrous joint restricted to fixation of
teeth in alveolar sockets of the maxilla
or mandible. The root of tooth is
attached to the socket with in alveolus
by periodontal ligament.

10. CARTILAGINOUS JOINTS
In this type of joint the bones are joined by
cartilage.
There are two types of cartilaginous joints:
1. Primary cartilaginous joints
2. Secondary cartilaginous joints

11. 1. Primary cartilaginous joints
joints - Known as "synchondroses".
Bones forming joints are connected
by a plate of hyaline cartilage.
These joints are immovable and
mostly temporary in nature. This
cartilage may ossify with age.
Examples in humans are the
joint between the first rib and
the manubrium of the sternum
Joint between epiphysis and
diaphysis of growing long bone.

14. 2. Secondary cartilaginous joints
Known as "symphysis". In these joints the
articular surfaces of bone forming the joints are
covered by thin plates of hyaline cartilage,which are
connected by a disc of fibrocartilage.
Example:-symphysis pubis
Intervertebral disc
Manubriosternal joint
Symphysis menti.

15. SYNOVIAL JOINTS
These joints possess a cavity and the articular ends of bones
forming the joint are enclosed in a fibrous capsule.As a
result they are seprated by a narrow cavity,the articular
cavity,which is filled with a fluid called synovial fluid.

16. Characteristic features
The articular surfaces are covered by a thin plate of
hyaline cartilage.
The joint cavity is enveloped by an articular capsule
which consists of outer fibrous capsule and inner synovial
membrane.
The cavity of joint is lined everywhere by synovial
membrane except over articular cartilages.
The cavity is filled with synovial fluid secreted by
synovial membrane which provides nutrition to
articular cartilage and lubrication of articular surfaces.
Some joint cavity completely or incompletely divided by
articular disc/ menisc.

17. Types of synovial joints
Plane Joint
Hinge Joint
Pivot Joint
Condylar Joint
Ellipsoid joint
Saddle Joint
Ball-and-Socket Joint

18. Plane Joint
Articular surfaces are more or less
flat.
They permit gliding movements in
various directions.
Examples; intercarpal
joints,intertarsal joints,jts
between articular process of
adjacent vertebrae.

19. Dr. Vibhash Kumar
Hinge Joint
Hinge Joint: the articular surface are
pulley shaped. This type of joint permits
movement in one plane around transverse
axis. This movement consists of flexion
and extension.
These joints have strong collateral
ligaments to prevent other movements.
Two examples are the elbow joint, knee
joint, interphalangeal joint ,ankle joint.

20. Dr. Vibhash Kumar
Pivot Joint
The articular surface of one bone is
rounded and fits into concavity of
another bone.further,rounded part is
surrounded by a ligamentous ring.
Movement is limited to the
rotation around a central axis.
Examples of this type of joint are the
joints between the proximal ends of
the radius and ulna
.atlanto axial joint.

21. Condylar Joint
The round articular surface of one bone
fits into socket type articular surfae of
another bone.
The end of bone bearing round articular
surface is called condyle .these joint
permit movements in 2 direction.
Examples – right and left
temporomandibular joints. knee joint

22. Ellipsoid joint
Elliptical convex surface of one bone
articulates with elliptical concave surface
of another bone.
The movements are permitted in two
directions.
Eg; wrist joint , atlanto occipital
joint,metacarpo phalangeal
joints,metatarso phalangeal joint

23. Saddle Joint
Saddle Joint: The articular surfaces are
reciprocally saddle shaped i.e
.concavo -convex.this unique
artiulation is modified condyloid
joint that allows a wide range of
movement.
An example would be the joint
between the trapezium and the
metacarpal bones of the
thumb,sternoclavicular joint.

24. Ball-and-Socket Joint
Ball-and-Socket Joint: consists of a bone with a
ball-shaped head that attaches with the cup-
shaped cavity of another bone.
This type of joint allows for a wider range of
motion than any other kind.
It permits movement in all planes, and a
rotational movement around a central axis.
Two examples of this type of joint would be the
hip, shoulder joints and incudostapedial joint.

25. FUNCTIONAL CLASSIFICATION
Synarthrosis :- Synarthroses permit little or no mobility. Most
synarthrosis joints are fibrous joints.Egcranial sutures in adult.
Amphiarthrosis :-Amphiarthroses permit slight mobility. The two
bone surfaces at the joint are both covered in hyaline cartilage and
joined by strands of fibrocartilage. eg: secondary cartilaginous joints
Diarthrosis:- Permit a variety of movements. Only synovial joints
are diarthrodial.

26. Classification According to number of
articulating bones
Simple Joint: 2 articulation surfaces (eg. shoulder joint, hip joint)
Compound Joint: 3 or more articulation surfaces (eg. radiocarpal joint)
Complex Joint: 3 or more articulation surfaces and an articular disc or
meniscus (eg . knee joint)

27. PARTS OF AJOINTS
A). fibrous Capsule
B). Reinforcing Ligaments
C). Synovial membrane
D). Articular Cartilage
E). Articular Discs
F). Fatty Pads
G). Bursae Flattened sacs
that contain synovial fluid.
Function to reduce friction

28. PARTS OF AJOINTS

29. JOINT DISORDERS

30. JOINT DISEASE
A combination of pain and stiffness , leading to
loss of function, is a classic feature of joint
disease.
Usually one component will predominates as
stiffness in inflammation, and pain in
mechanical joint problem.
Therefore specific questions will establish
whether symptoms are mechanical (e.g.
degenerative joint disease & mechanical tear) or
inflammatory(e.g. rheumatoid arthritis or gout).

31. TYPES
Neuromecha-
nical disease
Inflammatory
disease
Metabolic
disease

32. Ankylosing Spondylitis
Ankylosing
Spondylitis is a
disease of the spine in
which there is gradual
loss of mobility in the
joints between the
vertebrae. It occurs
mainly in males
between the ages of
20 and 40.

33. Degenerative Disc Disease
Based on clinical
profile, the study
group was divided
into 4 categories:
degenerative disc
disease (DDD) with
intervertebral disc
prolapse (IVDP),
lumbar canal
stenosis (LCS) with
IVDP, tuberculosis
spine and trauma.

34. Behcet's syndrome
Behcet's syndrome is a disease that involves
inflammation of the blood vessels. It causes
problems in many parts of the body.
The most common symptoms are-
Sores in the mouth
Other skin sores
Swelling of parts of the eye
Pain, swelling and stiffness of the joints

35. Behcet's syndrome

36. Carpal Tunnel Syndrome
Carpal tunnel syndrome is fairly common.
Symptoms include numbness, tingling and a
burning pain in the hand. The symptoms start
off by occurring at night, often waking the
patient, later they may also be experienced
during the day and in some cases be so severe
they can interfere with the normal use of the
hand.

37. Carpal Tunnel Syndrome

38. Gonococcal arthritis
 Gonococcal arthritis is an infection of the joints,
tendons and muscles that occurs in those suffering from
gonorrhea. It affects more women than men and usually
appears before the age of 30.

39. Gout
 Gout is a chemical defect which causes
the accumulation in the bloodstream of a
waste product of metabolism also
known as uric acid.
 It is the deposition of crystals of uric
acid in the skin, joints and kidneys
which is responsible
for the symptoms.

40. Gout
What is gout? Gout is condition
characterized by an overload of
uric acid in the body and
recurring attacks of joint
inflammation (arthritis). Chronic
gout can lead to deposits of hard
lumps of uric acid in
and around the
joints, decreased
kidney function, and
kidney stones.

41. Juvenille Rheumatoid Arthritis (JRA)
Juvenile arthritis refers to a "childhood
arthritis" for children under the age of
sixteen affected by inflammatory arthritis.
Children can develop almost all types of
arthritis that affect adults, but the most
common type that affects children is juvenile
rheumatoid arthritis.

42. Juvenille Rheumatoid Arthritis (JRA)

43. Osteoarthritis
Osteoarthritis is a degenerative disease of
the joints, usually accompanied by pain
and stiffness.
It causes a great deal of pain and discomfort to
a large number of people and affects both
males and females alike. The cause of the
disease is not known but it is described as a
degenerative disorder developing with age.

44. Osteomalacia
Osteomalacia is a disease affecting mainly
adult women, where the bones are generally
softened due to the
impaired deposition of calcium. It is thought
to be caused by lack of vitamin D.

45. Osteoporosis
Osteoporosis is a disease in which the bones
are generally thinned. From the age of 20
everyone’s bones
become progressively thinner with age. In
osteoporosis this thinning becomes faster
than normal.

46. Raynaud's phenomenon
Raynaud’s phenomenon is most common in
young women. First the fingertips go white and
cold, the fingers become numb and may become
stiff due to the blood supply being temporarily
cut off. The condition may be
slight or severe. In severe cases small ulcers
may form on the fingertips and the nails may
also be affected.

47. Rheumatoid arthritis
 Rheumatoid arthritis is a chronic inflammatory
disease affecting the connective tissue of the
joints. At the onset there may be a general
feeling of being unwell, fatigue, and pain and
stiffness in the joints. It usually begins with the
joints in the fingers spreading to the wrists and
elbows.

48. Trauma
Fracture- any break in bone
 Closed or simple fracture – bone broken,
broken ends do not break the skin

49. Fracture cont.
Open or compound fracture- broken bones
pierce the skin and can lead to infection.
Open reduction –surgical intervention with
devices such as wires, metal plates, or screws to
hold the bones in alignment.

50. Fracture cont…
Greenstick – in children, bone bent and
splintered but never completely separates.

51. Fracture cont…
Treatment- cast,
possible surgery
depending how bad
the break is.
Comminuted –
splintered or broken
into many pieces.

52. Dislocation
Dislocation – bone
displaced from proper
position in joint.
Sprain- sudden or
unusual motion,
ligaments torn but joint
not dislocated.
Treatment – traction
pulling force used to
hold the bones in place
used for fractures of
long bones.

53. THANK YOU