Joint Pathology

Weight-bearing joints Knees, hips, spine Small joints Hands and feet 

Definition a systemic, chronic, inflammatory disease characterized by 

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An excellent reference book for an engineer or a physician interested in the spine. Each topic is written from the viewpoint of a biomechanician and the topics covered include kinetics and kinematics of vertebral joints, pathological disorders of the spine and their surgical management. Chapter 1 contains an introductory section on the intervertebral disc that describes its structure, function and biomechanics. 

Preliminary investigations on superficial structures show that contrast-enhanced ultrasonography may prove useful for assessing superficial lymph nodes (Rubaltelli et al. 2004), thyroid and parathyroid disease (Cosgrove 2004), muscle and joint pathologies (Krix et al. 2005 Weber et al. 2006), and breast masses (Cassano et al. 2006). 

Wilkes, C. H. 1989. Internal derangements of the temporomandibular joint. Pathological variations. Arch Otolaryngol Head Neck Surg 115(4) 469-77. 

Hyaluronic acid (HA) is a ubiquitous substance that is found in connective tissues, joints, muscles and in the skin. It is an essential glycosaminoglycan that acts as a network to transfer essential nutrients from the bloodstream to cells. Modern plastic surgery employs various synthetic forms of HA to improve skin aesthetics, to correct joint pathologies and to reconstruct the skin after injury. This chapter outlines some of the important aspects of HA and its implementation in modern reconstructive surgery. 

Roberts S et al (2006) Histology and pathology of the human intervertebral disc. J Bone Joint Surg Am 88(Suppl 2) 10-14... 

GM-CSF is undetectable in the serum of normal humans, and no normal cells have been shown to express this protein constitutively. Some transformed cells may constitutively express GM-CSF, and it is actively synthesised and secreted by antigen- and lectin-stimulated T cells and by endothelial cells and fibroblasts exposed to TNF, IL-1 or endotoxin. Other sources of GM-CSF include stimulated B lymphocytes, macrophages, mast cells and osteoblasts, whilst TNF and IL-1 can stimulate its production by acute myeloid leukaemia cells. Some solid tumours and synovial cells from rheumatoid joints may also express GM-CSF and this may be important in disease pathology. 

Figure 8.3. Morphological features of a normal and rheumatoid joint (a) the essential features of a healthy synovial joint (e.g. a knee joint) (b) the pathological features of a joint of a patient with rheumatoid arthritis.

An adjunct for the relief of skeletal muscle spasm caused by reflex spasm to local pathology (such as inflammation of the muscles or joints, or secondary to trauma) spasticity caused by upper motor neuron disorders athetosis stiff-man syndrome. Injectable diazepam may also be used as an adjunct in tetanus. 

Osteoarthritis proves to be a more complex disease than autoimmune disease, with multiple variable manifestations like knee, hip, hand, DIP, elbow, shoulder, and spinal joints OA, which have different risk factors. The etiology of OA is multifactorial with inflammatory, metabolic and mechanical causes. A number of personal and environmental risk factors, such as obesity, occupation, and trauma, may initiate various pathological pathways. OA comprises degeneration of articular cartilage together with changes in subchondral bone of the joint margins and mild intraarticular inflammation. 

B.D. Ferris, A quantitative study of the tissue reaction and its relationship to debris production from a joint implant, British journal of experimental pathology, 71 (3) 367—373,1990. 

For example, normal urine is supersaturated with calcium oxalate. To prevent formation of renal calculi (stones)719 an inhibitory glycoprotein is present and slows the formation and growth of crystals.720 Under some disease conditions calcium carbonate stones may form in pancreatic ducts. A17 kDa lectinlike glycoprotein called lithostatine has been proposed to inhibit stone formation by binding to certain planes on CaC03 microcrystals just as antifreeze proteins (Box 4-D) inhibit ice formation.721 However, this proposed function for lithostatine is doubtful.722 723 Pathological deposits of crystalline calcium pyrophosphate and basic calcium phosphates are sometimes present in joints,724 even in Neanderthal skeletons.725... 

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