Unfortunately, traction forces were not measured in this experiment due to incompatibility of available force measuring equipment with MRI.. Last, this work does not explain the magnitude of the sound caused by cavity formation. Although some have noted the production of sound during cavity formation through tribonucleation [ 48 — 50 ], the amplitude of the generated sound from these experiments would appear to be small whereas joint cracking can easily be heard across a room.
Given the above, our in vivo results may be the largest example of tribonucleation and subsequent sound production observed to date. Our data support the view that tribonucleation is the process which governs joint cracking. This process is characterized by rapid separation of surfaces with subsequent cavity formation, not bubble collapse as has been the prevailing viewpoint for more than a half century. Observed previously in vitro , this work provides the first in-vivo demonstration of tribonucleation on a macroscopic scale and as such, provides a new theoretical framework to investigate health outcomes associated with joint cracking.
This framework will allow scientists to compare and contrast this process against tribonucleation observed between inanimate surfaces, an approach that may reveal how joint cracking affects cartilaginous joint surfaces. Presently, the literature in this area is confusing in that the energy produced during joint cracking is though to exceed the threshold for damage[ 51 ], but habitual knuckle cracking has not been shown to increase joint degeneration [ 52 ].
Ultimately, by defining the process underlying joint cracking, its therapeutic benefits, or possible harms, may be better understood. Note that the joint surfaces stay in close contact. Then, as traction forces increase, a focal area of increased signal intensity is visualized prior to the critical point where rapid joint separation occurs and cavity formation is then visualized.
The authors wish to acknowledge the staff of the Peter S. Allen MR Research Centre for their invaluable assistance. GK is supported by the Canada Research Chairs program. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
National Center for Biotechnology Information , U. PLoS One. Published online Apr Gregory N. Jacob L. Qinghui Zhang, Academic Editor. Author information Article notes Copyright and License information Disclaimer.
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Competing Interests: The authors have declared that no competing interests exist. Received Aug 31; Accepted Jan This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. This article has been cited by other articles in PMC. S1 Video: Real-time cine magnetic resonance imaging of the human metacarpalphalangeal joint undergoing traction. Abstract Cracking sounds emitted from human synovial joints have been attributed historically to the sudden collapse of a cavitation bubble formed as articular surfaces are separated.
Introduction Background Sounds emitted from human synovial joints vary in their origin. History In , Roston and Wheeler Haines [ 1 ] published the first scientific study toward describing the origins of joint cracking. Materials and Methods Ethics Statement An adult male subject possessing the ability to crack his MCP joints provided full informed, written consent to participate in this study approved by the Human Ethics Research Board of the University of Alberta. Preparation Ten MCP joints from a single participant were studied over two sessions with one finger at a time isolated for imaging.
Open in a separate window. Fig 1. The radiofrequency coil inside the clear housing left. Imaging Imaging studies were performed on a Siemens Sonata 1. Joint Distraction With the subject prone, the hand and radiofrequency coil were secured to the imaging gantry then positioned in the magnet Fig. Image Analysis Static images were displayed with software supplied by the magnet manufacturer.
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Results All ten MCP joints imaged resulted in joint cracking as confirmed by the subject and the cable operator. Fig 2. T1 static images of the hand in the resting phase before cracking left. Fig 3. Still frames from a representative trial of joint cracking in the same MCP joint. Fig 4. Time series plots for joint separation distance and signal intensity over the course of a representative MCP joint cracking plots. Discussion This study employed cine MRI to visualize joint cracking in real time. Events consistent with tribonucleation Our results offer direct experimental evidence that joint cracking is the result of cavity inception within synovial fluid rather than collapse of a pre-existing bubble.
Interpretation of prior studies Our results are consistent with those of Roston and Wheeler Haines [ 1 ]. Limitations The slice thickness used for cine MRI prevented us from visualizing the joint in its entirety. Conclusions Our data support the view that tribonucleation is the process which governs joint cracking. TIF Click here for additional data file. S1 Video Real-time cine magnetic resonance imaging of the human metacarpalphalangeal joint undergoing traction.
MP4 Click here for additional data file. Acknowledgments The authors wish to acknowledge the staff of the Peter S. Data Availability All relevant data are within the paper and its Supporting Information files. References 1.
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Cracking in the metacarpo-phalangeal joint. J Anat. Fick R. Zum Streit um den Gelenkdruck Anat Hefte. Springer-Verlag; ; 43 : — Christen T. Richtigstellung zum Streit um den Gelenkdruck.
Anat Hefte. Nordheim Y. Eine neue Methode den Gelenkknorpel besonders die Kniegelenkmenisken rontgenologisch darzustellen. Fortschr Rontgenstr.
Ann Rheum Dis. On the pressure developed in a liquid during the collapse of a spherical cavity.
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Philos Mag Ser 6. New York: McGraw-Hill; Synovial fluid cavitation during distraction radiography of the coxofemoral joint in dogs. J Am Vet Med Assoc.
Manipulation and mobilization of the third metacarpophalangeal joint: a quantitative radiographic and range of motion study. Man Med. Evans DW, Lucas N. A reappraisal.
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Man Ther. Elsevier Ltd ; ; 15 : — A study of the tensile properties of liquids in confined spaces using an atomic force microscope. Evidence-informed management of chronic low back pain with spinal manipulation and mobilization. Spine J. Castellanos J, Axelrod D. Effect of habitual knuckle cracking on hand function. J Biomech. Quantification of cavitation and gapping of lumbar zygapophyseal joints during spinal manipulative therapy.
J Manipulative Physiol Ther. DiGiorgi D.
Spinal manipulation under anesthesia: a narrative review of the literature and commentary. Chiropr Man Therap. WaveSurfer may be extended by plug-ins as well as embedded in other applications. WaveSurfer is a free software application from the Other subcategory, part of the Education category. The app is currently available in English and it was last updated on WaveSurfer version 1. Just click the green Download button above to start. Until now the program was downloaded times.
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