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Functional Classification of Joints01:09

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The functional classification of joints is determined by the amount of mobility between the adjacent bones. Joints are functionally classified as a synarthrosis or immobile joint, an amphiarthrosis or slightly moveable joint, or as a diarthrosis, a freely moveable joint. Fibrous and cartilaginous joints can be functionally classified as either synarthroses  or amphiarthroses, whereas all synovial joints are classified as diarthroses.
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Joints, also known as articulations, are classified based on their structural characteristics, i.e., based on whether the articulating surfaces of the adjacent bones are directly connected by fibrous connective tissue or cartilage, or whether the articulating surfaces contact each other within a fluid-filled joint cavity. These differences serve to divide the joints of the body into three structural classifications.
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Asthma is a prevalent chronic respiratory condition marked by inflammation and hyperresponsiveness of the airways. Its pathophysiology involves complex interactions among inflammatory pathways, immune responses, and neural mechanisms.
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Introduction to Joints00:58

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The adult human body usually has 206 bones, and except for the hyoid bone in the neck, each bone is connected to at least one other bone. Joints are the location where bones come together. Many joints allow for movement between the bones. At these joints, the articulating surfaces of the adjacent bones can move smoothly against each other. However, the bones of other joints may be joined by connective tissue or cartilage. These joints are designed for stability and provide little or no...
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Axial spondyloarthritis: concept, construct, classification and implications for therapy.

Philip C Robinson1,2, Sjef van der Linden3,4, Muhammad A Khan5

  • 1School of Clinical Medicine, Faculty of Medicine, University of Queensland, Brisbane, Australia. philip.robinson@uq.edu.au.

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Axial spondyloarthritis (axSpA) classification has evolved beyond erosions to a spectrum of disease, incorporating advanced imaging and genetics. Ongoing research aims to refine diagnostic criteria for better patient classification and management.

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Area of Science:

  • Rheumatology
  • Immunology
  • Medical Imaging

Background:

  • The concept of axial spondyloarthritis (axSpA) has significantly evolved since the 1984 modified New York criteria for ankylosing spondylitis.
  • Advances in imaging, therapeutics, and genetics have broadened the understanding of axSpA from sacroiliac joint erosions to a spectrum of disease, including cases without radiographic changes.

Purpose of the Study:

  • To review the evolving disease concept of axSpA.
  • To discuss the impact of new diagnostic modalities and the need for updated classification criteria.
  • To highlight ongoing debates regarding the operationalization of axSpA classification, such as the requirement for objective inflammation evidence.

Main Methods:

  • Review of scientific literature and clinical practice evolution.
  • Analysis of the impact of Magnetic Resonance Imaging (MRI) on axSpA diagnosis.
  • Discussion of the ongoing CLASSIC study evaluating current classification criteria specificity.

Main Results:

  • MRI has substantially changed the diagnosis and differential diagnosis of axSpA.
  • There is a recognized need for new classification criteria due to the evolving disease concept.
  • Disagreement persists regarding the requirement for objective demonstration of axial inflammation for axSpA classification.

Conclusions:

  • The classification criteria for axSpA require ongoing revision in light of new imaging technologies, biomarkers, and genetic data.
  • Further understanding of axSpA biology is expected to resolve current discrepancies in classification and diagnosis.
  • The evolving axSpA disease concept necessitates adaptive diagnostic and classification strategies.