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Dental Clinics of North America Apr 2023Temporomandibular joints (TMJ) are one of the most complex joints. Each one is located on one side of the face, and are composed of mandibular fossa, joint tubercle, and... (Review)
Review
Temporomandibular joints (TMJ) are one of the most complex joints. Each one is located on one side of the face, and are composed of mandibular fossa, joint tubercle, and condylar process of mandible, separated by an articular disk. To these structures are attached ligaments and muscles, which will provide stability and movement. When TMJs work properly, jaw movements can be performed without pain or discomfort. It is important to mention that the complex formed by both TMJs will confront the maxillary with the mandibular bone and therefore will be related to the occlusion, linking these structures during growth and development.
Topics: Humans; Mandibular Condyle; Temporomandibular Joint Disc; Temporomandibular Joint; Mandible; Temporomandibular Joint Disorders
PubMed: 36965926
DOI: 10.1016/j.cden.2022.11.003 -
Osteoarthritis and Cartilage Dec 2021Prevention is an attractive solution for the staggering and increasingly unmanageable burden of osteoarthritis. Despite this, the field of osteoarthritis prevention is... (Review)
Review
Prevention is an attractive solution for the staggering and increasingly unmanageable burden of osteoarthritis. Despite this, the field of osteoarthritis prevention is relatively immature. To date, most of what is known about preventing osteoarthritis and risk factors for osteoarthritis is relative to the disease (underlying biology and pathophysiology) of osteoarthritis, with few studies considering risk factors for osteoarthritis illness, the force driving the personal, financial and societal burden. In this narrative review we will discuss what is known about osteoarthritis prevention, propose actionable prevention strategies related to obesity and joint injury which have emerged as important modifiable risk factors, identify where evidence is lacking, and give insight into what might be possible in terms of prevention by focussing on a lifespan approach to the illness of osteoarthritis, as opposed to a structural disease of the elderly. By targeting a non-specialist audience including scientists, clinicians, students, industry employees and others that are interested in osteoarthritis but who do not necessarily focus on osteoarthritis, the goal is to generate discourse and motivate inquiry which propel the field of osteoarthritis prevention into the mainstream.
Topics: Bone Malalignment; Exercise; Genetic Predisposition to Disease; Health Behavior; Health Promotion; Humans; Joints; Muscle Weakness; Osteoarthritis; Overweight; Patient Education as Topic; Risk Factors; Sex Factors
PubMed: 34560260
DOI: 10.1016/j.joca.2021.06.015 -
Biomedicine & Pharmacotherapy =... Sep 2020Osteoarthritis (OA) is the most prevalent joint degenerative disease leading to irreversible structural and functional changes in the joint and is a major cause of... (Review)
Review
Osteoarthritis (OA) is the most prevalent joint degenerative disease leading to irreversible structural and functional changes in the joint and is a major cause of disability and reduced life expectancy in ageing population. Despite the high prevalence of OA, there is no disease modifying drug available for the management of OA. Oxidative stress, a result of an imbalance between the production of reactive oxygen species (ROS) and their clearance by antioxidant defense system, is high in OA cartilage and is a major cause of chronic inflammation. Inflammatory mediators, such as interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) are highly upregulated in OA joints and induce ROS production and expression of matrix degrading proteases leading to cartilage extracellular matrix degradation and joint dysfunction. ROS and inflammation are interdependent, each being the target of other and represent ideal target/s for the treatment of OA. Plant polyphenols possess potent antioxidant and anti-inflammatory properties and can inhibit ROS production and inflammation in chondrocytes, cartilage explants and in animal models of OA. The aim of this review is to discuss the chondroprotective effects of polyphenols and modulation of different molecular pathways associated with OA pathogenesis and limitations and future prospects of polyphenols in OA treatment.
Topics: Animals; Anti-Infective Agents; Antioxidants; Antirheumatic Agents; Humans; Inflammation Mediators; Joints; Osteoarthritis; Oxidative Stress; Polyphenols; Reactive Oxygen Species; Signal Transduction
PubMed: 32768946
DOI: 10.1016/j.biopha.2020.110452 -
The Journal of the American Academy of... Feb 2020Evaluation of periarticular traumatic wounds for joint penetration is a common clinical concern for orthopaedic surgeons. Wounds that violate the joint capsule can... (Review)
Review
Evaluation of periarticular traumatic wounds for joint penetration is a common clinical concern for orthopaedic surgeons. Wounds that violate the joint capsule can result in deep infection and sepsis. Understanding the anatomic landmarks and capsular extensions of the major joints is key to proper evaluation. Initial evaluation of periarticular wounds includes thorough examination of the wound and plain radiographs. Historically, the saline load test has been the diagnostic test of choice for assessing traumatic arthrotomy; however, CT has recently been shown to have excellent sensitivity and specificity for detecting open knee joint injuries. Current treatment of traumatic arthrotomy includes intravenous antibiotics and surgical irrigation and débridement. Future areas of research must focus on further validation of CT evaluation and its use in other major joints, standardizing antibiotic treatment, and further delineating the role of nonsurgical management in minor injuries.
Topics: Diagnostic Tests, Routine; Humans; Joints; Saline Waters; Wounds and Injuries
PubMed: 31977606
DOI: 10.5435/JAAOS-D-19-00153 -
The Journal of the American Academy of... Aug 2023Midcarpal instability (MCI) of the wrist represents multiple distinct clinical entities that all have in common abnormal force transmission across the midcarpal joint....
Midcarpal instability (MCI) of the wrist represents multiple distinct clinical entities that all have in common abnormal force transmission across the midcarpal joint. This can be asymptomatic but can also result in painful wrist motion, a characteristic catch-up clunk, and symptoms of instability. The carpus is stabilized by numerous extrinsic and intrinsic ligaments. Dynamic joint reactive forces between the proximal and distal carpal rows help create reciprocal motion, which results in smooth, physiologic wrist mechanics. Diagnosis of MCI requires a thorough history, physical examination, and adequate imaging. MCI can be managed nonsurgically with activity modification, physical therapy, specialized orthotics, medications, and corticosteroid injections. A variety of surgical treatment options exists to treat symptomatic MCI. These include arthroscopic thermal capsulorrhaphy, ligament repair or reconstruction, radial osteotomies, and limited radiocarpal or intercarpal fusions. Capsulorrhaphy or ligament repair is favored for mild to moderate cases; osteotomies can be used for the correction of bony deformities contributing to instability, whereas partial wrist arthrodesis is indicated for severe or recurrent instability and fixed deformities.
Topics: Humans; Joint Instability; Ligaments, Articular; Wrist Joint; Carpal Joints; Carpal Bones
PubMed: 37105177
DOI: 10.5435/JAAOS-D-22-00777 -
Foot and Ankle Clinics Dec 2022A triple arthrodesis is comprised of subtalar, talonavicular, and calcaneocuboid joints arthrodesis. A pantalar arthrodesis is triple arthrodesis combined with... (Review)
Review
A triple arthrodesis is comprised of subtalar, talonavicular, and calcaneocuboid joints arthrodesis. A pantalar arthrodesis is triple arthrodesis combined with tibiotalar arthrodesis. The goal of the procedure is to obtain a correction of deformity and achieve a plantigrade, functional, painless, stable, weightbearing foot that can be used to ambulate. This is done by creating an osseous continuity across the ankle, subtalar, and talonavicular, and calcaneocuboid joints. There are several approaches and fixation strategies that result in successful clinical union and should be chosen to match the clinical situation. Modern techniques result in high rates of union and pain relief.
Topics: Humans; Subtalar Joint; Arthrodesis; Tarsal Joints; Ankle Joint; Weight-Bearing
PubMed: 36368803
DOI: 10.1016/j.fcl.2022.08.002 -
The Veterinary Clinics of North... Jul 2022Indications for injecting synovial joints may include diagnostic, therapeutic, or combination. Diagnostic injectates aim to reduce or eliminate the contribution of pain... (Review)
Review
Indications for injecting synovial joints may include diagnostic, therapeutic, or combination. Diagnostic injectates aim to reduce or eliminate the contribution of pain to lameness and may be assessed both subjectively or objectively by the clinician. Diagnostic joint injections are not specific for a disease and their limitations must be remembered when interpreting a response-including false-negative results. Patient selection and sterile technique throughout the procedure minimize adverse effects. Risks of intra-articular (IA) injections may include transient soreness, cartilage damage, and, rarely, septic arthritis. Ultrasound guidance with a trained clinician may provide further benefits including the reduction of periprocedural discomfort, reduction in iatrogenic cartilage damage during needle insertion, and improvement in synovial fluid feedback. The removal of some synovial fluid before administering an IA injection should be considered to confirm needle placement, provide diagnostic sampling, and help accommodate injectate volume.
Topics: Animals; Injections, Intra-Articular; Joints; Synovial Fluid; Ultrasonography
PubMed: 35562222
DOI: 10.1016/j.cvsm.2022.02.004 -
Seminars in Musculoskeletal Radiology Oct 2019Osteoarthritis (OA) is the most common joint disease in the United States. The prevalence of OA is rising due to an aging population and increasing rates of obesity.... (Review)
Review
Osteoarthritis (OA) is the most common joint disease in the United States. The prevalence of OA is rising due to an aging population and increasing rates of obesity. Magnetic resonance imaging (MRI) allows an incomparable noninvasive assessment of all joint structures. Irreversible and progressive degradation of the articular cartilage remains the hallmark feature of OA. To date, attempts at developing disease-modifying drugs or biomechanical interventions for treating OA have proven unsuccessful. MRI-based cartilage imaging techniques have continued to advance, however, and will likely play a central role in the development of these joint preservation methods of the future. In this narrative review, we describe clinical MR image acquisition and assessment of cartilage. We discuss the semiquantitative cartilage scoring methods used in research. Lastly, we review the quantitative MRI techniques that allow assessment of changes in the biochemical composition of cartilage, even before the morphological changes are evident.
Topics: Cartilage, Articular; Humans; Joints; Magnetic Resonance Imaging; Osteoarthritis
PubMed: 31556090
DOI: 10.1055/s-0039-1695720 -
Seminars in Musculoskeletal Radiology Jun 2021Osteoarthritis, characterized by the breakdown of articular cartilage and other joint structures, is one of the most prevalent and disabling chronic diseases in the... (Review)
Review
Osteoarthritis, characterized by the breakdown of articular cartilage and other joint structures, is one of the most prevalent and disabling chronic diseases in the United States. Magnetic resonance imaging is a commonly used imaging modality to evaluate patients with joint pain. Both two-dimensional fast spin-echo sequences (2D-FSE) and three-dimensional (3D) sequences are used in clinical practice to evaluate articular cartilage. The 3D sequences have many advantages compared with 2D-FSE sequences, such as their high in-plane spatial resolution, thin continuous slices that reduce the effects of partial volume averaging, and ability to create multiplanar reformat images following a single acquisition. This article reviews the different 3D imaging techniques available for evaluating cartilage morphology, illustrates the strengths and weaknesses of 3D approaches compared with 2D-FSE approaches for cartilage imaging, and summarizes the diagnostic performance of 2D-FSE and 3D sequences for detecting cartilage lesions within the knee and hip joints.
Topics: Cartilage, Articular; Hip Joint; Humans; Imaging, Three-Dimensional; Knee Joint; Magnetic Resonance Imaging
PubMed: 34547805
DOI: 10.1055/s-0041-1730913 -
Current Rheumatology Reviews 2020
Topics: Carpal Joints; Carpometacarpal Joints; Cartilage, Articular; Hand Joints; Humans; Osteoarthritis; Wrist Joint
PubMed: 32967606
DOI: 10.2174/157339711603200922105536