Synovial fluid

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Synovial fluid is a thick, stringy fluid found in the cavities of synovial joints. With its egg-like consistency ("synovial" partially derives from ovum, Latin for egg), synovial fluid reduces friction between the articular cartilage and other tissues in joints to lubricate and cushion them during movement.

[edit] Overview

The inner membrane of synovial joints is called the synovial membrane and secretes synovial fluid into the joint cavity. This fluid forms a thin layer (roughly 50 μm) at the surface of cartilage, but also seeps into microcavities and irregularities in the articular cartilage surface, filling all empty space [1]. The fluid within articular cartilage effectively serves as a synovial fluid reserve. During movement, the synovial fluid held within the cartilage is squeezed out mechanically to maintain a layer of fluid on the cartilage surface (so-called weeping lubrication).

[edit] Composition

Synovial tissue is composed of vascularized connective tissue that lacks a basement membrane. Two cells type (type A and type B) are present: type B produce synovial fluid. Synovial fluid is made of hyaluronic acid and lubricin, proteinases and collagenases. Synovial fluid exhibits non-Newtonian flow characteristics. The viscosity coefficient is not a constant, the fluid is not linearly viscous, and its viscosity increases as the shear rate decreases.

Normal synovial fluid contains 3-4 mg/ml hyaluronan (hyaluronic acid), a polymer of disaccharides composed of D-glucuronic acid and D-N-acetylglucosamine joined by alternating beta-1,4 and beta-1,3 glycosidic bonds [2]. Hyaluronan is synthesized by the synovial membrane and secreted into the joint cavity to increase the viscosity and elasticity of articular cartilages and lubricate the surfaces between synovium and cartilage.[3]

Synovial fluid also contains lubricin secreted by synovial cells. It is chiefly responsible for so-called boundary-layer lubrication, which reduces friction between opposing surfaces of cartilage. There is also some evidence that it helps regulate synovial cell growth.[4]

Its functions are:

reducing friction by lubricating the joint, absorbing shocks, and supplying oxygen and nutrients to and removing carbon dioxide and metabolic wastes from the chondrocytes within articular cartilage.

It also contails phagocytic cells that remove microbes and the debris that results from normal wear and tear in the joint.

[edit] Health and disease

[edit] Collection

Synovial fluid can be collected by syringe in a procedure termed arthrocentesis, also known as joint aspiration.

[edit] Classification

Synovial fluid can be classified into normal, noninflammatory, inflammatory, septic, and hemorrhagic:

Classification of synovial fluid in an adult knee joint
Normal Noninflammatory Inflammatory Septic Hemorrhagic
Volume (ml) <3.5 >3.5 >3.5 >3.5 >3.5
Viscosity High High Low Mixed Low
Clarity Clear Clear Cloudy Opaque Mixed
Color Colorless/straw Straw/yellow Yellow Mixed Red
WBC/mm3 <200 200-2,000 2,000-75,000 >100,000 Same as blood
Polys (%) <25 <25 >50 >75 Same as blood
Gram stain Negative Negative Negative Often positive Negative

[edit] Pathology

Many synovial fluid types are associated with specific diagnoses [5][6]:

Noninflammatory (Group I) Inflammatory (Group II)
Rheumatoid arthritis Reactive arthritis Psoriatic arthritis Acute rheumatic fever Acute gout or pseuodgout Scleroderma Polymyositis Systemic lupus erythematosus Ankylosing spondylitis Inflammatory bowel disease arthritis Infection (viral, fungal, bacterial) including Lyme disease Acute crystal synovitis
Septic (Group III) Hemorrhagic

[edit] Joints cracking

Main article: Cracking joints

When two parts forming a joint are pulled away from each other, the joint capsule increases in volume but the synovial fluid in the capsule no longer fills it all. Gases dissolved in the fluid quickly fill the empty space causing a sharp cracking sound.[7] The general term for this is cavitation.

[edit] Additional images

[edit] References

[edit] External links

Warman W. "Delineating biologic pathways involved in skeletal growth and homeostasis through the study of rare Mendelian diseases that affect bones and joints." Arthritis Res. Ther. 2003, 5(Suppl 3):5 [1] Hyaluronan: structure and properties Normal joint structure, from University College London Principles of anatomy and physicology 12th edition by gerard j. tortora and bryan derrickson.


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