Related Topics
From Musculoskeletal System
Pivot Joints
e.g., atlanto-axial joint
1. Overview
A pivot joint, also known as a trochoid joint, is a type of synovial joint that allows rotational movement around a single axis. It functions like a mechanical axle, enabling one bone to rotate around another. Pivot joints are essential for motions such as head rotation and forearm pronation and supination. Though limited in range, they play a vital role in daily motor activities.
2. Location
There are two primary pivot joints in the human body:
Atlantoaxial joint (cervical spine): Located between the first (atlas) and second (axis) cervical vertebrae; allows head rotation side-to-side (e.g., "no" movement).
Proximal radioulnar joint (forearm): Located near the elbow, between the head of the radius and the radial notch of the ulna; enables pronation and supination of the forearm.
3. Structure
A pivot joint consists of a rounded or pointed bone that rotates within a ring formed by another bone and a ligament:
Bone component: One bone has a bony process (e.g., the dens of the axis or the radial head).
Ring or sleeve: This may be bony (e.g., atlas) or ligamentous (e.g., annular ligament of the radius).
Joint capsule: A fibrous capsule encloses the joint, allowing synovial fluid to lubricate and reduce friction.
Ligaments: Support and limit the range of motion; examples include the transverse ligament of the atlas and annular ligament in the elbow.
4. Function
Pivot joints allow uniaxial rotation around a central axis:
Rotation: The only permitted motion; no flexion, extension, abduction, or adduction.
Example in neck: Rotation of the head left and right via the atlantoaxial joint.
Example in forearm: Pronation (palm down) and supination (palm up) movements via the proximal radioulnar joint.
5. Physiological role(s)
Pivot joints are essential for specific physiological tasks and functional mobility:
Vision and awareness: The atlantoaxial pivot joint allows the head to rotate and track visual or auditory stimuli.
Tool manipulation: The radioulnar pivot enables rotational forearm movement, allowing gripping, turning, and writing.
Neuromuscular coordination: Smooth rotational movement supports coordinated motor skills in upper limb and neck.
6. Clinical Significance
Though small, pivot joints are subject to specific injuries and disorders:
Atlantoaxial instability:
May be congenital (e.g., Down syndrome) or acquired (e.g., rheumatoid arthritis), posing a risk for spinal cord compression.
Rotational subluxation:
Occurs when the atlas and axis misalign; can lead to torticollis or restricted head movement.
Radial head dislocation (nursemaid’s elbow):
Common in young children; results from sudden traction on the forearm causing the radial head to slip out of the annular ligament.
Fractures:
Radial head fractures can impair pronation and supination; dens fractures affect cervical rotation and may compromise neural structures.
Rheumatoid arthritis:
Chronic inflammation may erode ligaments or bones, especially in the cervical spine, destabilizing the pivot joint.
Did you know? Bones are living tissue that is constantly remodeling and repairing itself.