Joints occur where at least two bones meet, and they allow the bones
to move with respect to one another. For example, the elbow is the
joint between the one upper and two lower bones of the
arm. The job of a joint is to make repeated movement between the bones smooth,
safe, and efficient.
Joints are made up of several parts, each one needed to allow the
joint to function properly.
Scleroderma is often hard to diagnose, since it may look like many other diseases. Your doctor will do a physical exam and take your medical history. He or she will look for changes in skin thickness and do some tests.
One test that doctors use is the nail-fold capillary test. This focuses on one of the earliest signs of scleroderma: the disappearance of tiny blood vessels in the skin of the hands and feet. Doctors also check the blood for specific signs. Your doctor may remove a small tissue sample...
Cartilage: The ends of
bones that meet at the joint are covered by a smooth substance (cartilage) that serves both as a shock absorber and as
a tough coat to prevent damage to the underlying bone.
Muscles: Bones are linked together by muscles, strong tissues
that provide the force to move the bones.
Ligaments: Bones are also linked together by
ligaments, strong tissues that form the outer
covering, or capsule, of the joint.
Joint fluid: Specialized cells called synoviocytes that line the inner surface
of the joint capsule fill the
joint with a thin cushion of fluid (synovial fluid),
which absorbs shocks and prevents the bones from hitting each
Bursa: The joint is surrounded by
bursae, fluid-filled pockets that provide buffering
where there might otherwise be friction between the skin and joint, between two
bones, and between a tendon or a ligament and a bone.
The importance of shock absorption
If you have healthy joints, when you stomp your foot down on the
floor, you do not get a sensation of searing pain shooting through your knee.
This is quite remarkable, since the force of your thigh muscles ought to slam
the bones of your upper leg crashing down onto the bones of your lower leg.
This doesn't happen because tissues within the joint serve as shock absorbers,
like springs that absorb energy, and thus slow down the transfer of force from
one bone to the next.
The shock-absorbing properties of the joint are due primarily to the
cartilage and the thin cushion of fluid that fills the space between the
The cartilage covering the ends of all the bones that meet at a joint
is a Teflon-like substance that is both very hard and very smooth. Cartilage is
made up of cells that receive their nourishment from a solution called synovial
fluid that fills the inside of the joint space. Synovial fluid contains
proteins and sugars and is produced by a layer of cells lining the joint.
Synovial fluid is thick like molasses, enabling it to protect the joint from
transmitting the normal forces associated with movement to the underlying
The mix of cells and surrounding solution acts much like a sponge.
For example, with each step downward, fluid is squeezed out of the cartilage of
the knee. When pressure is released as the leg comes up off the ground, fluid
rushes back into the cartilage, and it springs back into shape.