m Inflammation in joints characterized by redness,

warmth, swelling & pain.

m ñ

  joint,   inflammation͟
m Many types of arthritis, most common are:
m Osteoarthritis
m Rheumatoid Arthritis
m Psoriatic arthritis
m Gouty arthritis
m Tubercular arthritis
m Septic arthritis
m Structure that joins two or more adjacent
bones of the skeleton.

Joint Classification
m Fibrous (immoveable)
m Cartilagenous
(partially moveable)
m Synovial
(freely moveable).
m Jibrous joints
¦ This type of joint is held together by only a ligament.
Examples are where the teeth are held to their bony
sockets and at both the radioulnar and tibiofibular
joints.
m 3artilagenous
¦ These joints occur where the connection between the
articulating bones is made up of cartilage for example
between vertebrae in the spine.
m Synovial Joints
¦ Synovial joints are by far the most common classification of
joint within the human body.
¦ Jive classes of tissue make up synovial joints:
ë one
ë 3artilage
ë Synovium
ë Synovial fluid
ë Tensile tissues:
Ligament and tendon.
 0ormal articular cartilage is strategically located at the ends of bones to perform two
functions:
¦ bathed in synovial fluid, it ensures virtually friction-free movements within the
joint; and
¦ in weight-bearing joints, it spreads the load across the joint surface in a manner
that allows the underlying bones to absorb shock and weight without being
crushed.

 These functions require the cartilage to be elastic (i.e., to regain normal architecture
after being compressed) and for it to have unusually high tensile strength.

 These attributes are provided by the two major components of the cartilage: a special
type of collagen (type II) and proteoglycans, both secreted by chondrocytes.

 As is the case with adult bones, articular cartilage is not static; it undergoes turnover
in which "worn out" matrix components are degraded and replaced. This balance is
maintained by chondrocytes, which not only synthesize the matrix but also secrete
matrix-degrading enzymes.

 Thus, the health of the chondrocytes and their ability to maintain the essential
properties of the cartilage matrix determine joint integrity.
m Synoviocytes - synovial lining
cells

m Produce degradative enzymes

(collagenases).
m Produce synovial fluid which
assists in lubrication of joints
& nutrition to cartilage.
Functions:
m Controls diffusion
m Ingest debris
m Secrete:
m Immunoglobulins
m lysosomal enzymes
m Hyaluronate
m lubricating glycoproteins

m Reduces friction in joint

m Highly viscous fluid synthesized by synovial lining cells.

m It contains:
m Gyaluronate (hyaluronic acid)
m Glycoprotein called lubricin
m î o functionsd

m 0utrition: Synovial fluid is the medium by which

nutrients are carried to & wastes are carried from,
the avascular components of the joint.

m ubrication: Gyaluronic acid is important for the

lubrication of the joint capsule while lubricin is
necessary for cartilage lubrication.
m 3onsists of cartilage cells & cartilaginous matrix.
m 3artilaginous matrix is composed of:
m Collagen-II fibers: maintain the structural integrity of the
tissue
m Àroteoglycans: highly viscous & hydrophilic, provide the
resiliency of the articular cartilage & contribute to the
lubrication of the weight bearing surfaces.
m 3artilage is avascular, contains no nerves.
m Provides low friction surface
m 3ontains type II collagen (tensile strength)
m Proteoglycan having water holding capacity
m 3ollagen meshwork entraps proteoglycans to produce a
fiber-reinforced hydrated gel which resists compression.
m 3ollagen & Proteoglycan turnover depends on balance
between many enzymes.
m When proteoglycans are lost, cartilage softens &
loosed its resilience.
m Joint ligaments: 3ollagen fibers
joining one bone to the other.

m Joint tendon & bursae:

m Tendons join muscles with
bone.
m ursae: areolar tissue seen
over areas of friction (between
muscles & tendons).
m inflamed ursae & tendon:
(bursitis & tenosynovitis)
m 3hronic, systemic inflammatory disorder
m Principally attacks synovial joints.
m Produces an inflammatory response of the
synovium (synovitis).
m Destruction of articular cartilage & ankylosis of the
joints.
m Disabling and painful condition.
m Lead to substantial loss of functioning and mobility.
m This symmetry
helps distinguish
RA from other
arthritis.
m Gighly inflammatory polyarthritis.
m Leading to joint destruction, deformity & loss of
function.
m Symmetric swelling of peripheral joints is the
hallmark of the disease.
m Extra-articular features & systemic symptoms
commonly occurs.
m About 1-2% of the world's population is affected.
m women three times more often than men.
m Onset is between the ages of 40 & 50, but people of
any age can be affected.
m Prevalence increases with age, approaching 5% in
women over age 55.
m Gave a genetic predisposition.
m Ability to resist/avoid infection, disease, by means of
antibodies & W3.
m Humoral immunity: mediated by antibodies by -cells.
m Cellular immunity: cells like macrophages, T- cells, & the
release of cytokines in response to an antigen.
m uto-immunity: Jailure of an organism to recognize its own
parts as £
£, results in an immune response against its own
cells. Any disease results from such an abnormal immune
response is called  




.
 Immunity

Innat a tiv

Physical 3h mical Inflammation

3 llular Gumoral
ºhen a monocyte enters damaged tissue through the blood vessel it become a  

 ymphocytes

T cells  cells 0atural killer cells

(3ell mediated immunity) (Antibody formation)

Gelper T 3ytotoxic Regulatory Memory T 0atural Killer 3ells

cells T 3ells T cells cells (0k cells)
(3D4+) (3D8+) (suppressor
T cells)

3D= cluster of differentiation