Joint Injuries and Disorders Introduction A joint is where two or more bones come together. Your joints include the knees, hips, elbows and shoulders. There are many types of joint disorders, including arthritis, bursitis and dislocations. Treatment for joint disorders depends on the cause and severity of the disorder. Treatments may include medicine, surgery or other treatments. This reference summary explains joint disorders. It talks about common disorders of the joint as well as treatment options. Anatomy Our bones help us stand up straight. Our muscles help our bones move together. Bones connect at the joints. Examples of joints include the: Shoulders. Elbows. Wrists. Hips. Knees. We have joints between the different bones of our fingers and toes. We also have joints that allow our vertebrae to move. Vertebrae are the bones in the spine. Bone Synovium Cartilage Cartilage covers the ends of the bones of a joint. Cartilage is a tissue that keeps the bones from rubbing against each other during motion. There is a bag that contains a small amount of fluid called synovium between the two pieces of cartilage in a joint. The combination of cartilage and synovium allows for smooth, painless motion in your joints. 1
A bursa is a small, fluid-filled sac that acts like a cushion between a bone and other moving body parts such as muscles, tendons or skin. They are lined with synovial membranes. Symptoms Many joint disorders have similar symptoms. The main symptoms are pain and swelling in or around the affected joint. The pain may be dull or severe. Certain activities, such as climbing stairs and straightening a limb, may increase pain. In some cases, the pain may be relieved by rest. Other common symptoms of joint disorders are: A joint that locks or buckles. A stiff joint. Clicking or popping noises from the joint. Weakness in the joint. Talk to your health care provider if you notice any of these symptoms or other changes. Finding a problem early makes treatment easier in most cases. Arthritis Arthritis is the most common disease that affects the joints. Arthritis causes the cartilage in a joint to wear away over time. This can cause pain and swelling. There are many types of arthritis. Osteoarthritis is due to chronic wear and tear. The cartilage wears away and causes changes to the bone. It is more common in older people. Posttraumatic arthritis is due to trauma to a joint. Trauma may happen during a car accident or a sports injury. Rheumatoid arthritis causes swelling, redness and tenderness in the joint. It is an autoimmune disease. This means the immune system attacks healthy tissue in the body. In rheumatoid arthritis, the synovium is attacked and becomes inflamed. This leads to damage of the synovium and joint. 2
Other types of arthritis that can affect the joints include: Ankylosing spondylitis. Gout. Infectious arthritis. Psoriatic arthritis. Ankylosing spondylitis is an inflammatory type of arthritis. It usually affects the joints in the spine. Gout is a painful type of arthritis. It happens when crystals of uric acid build up in the joints. Uric acid is a waste product of the body. Infectious arthritis is an infection in the joint. The infection comes from a bacterial, viral or fungal infection that spreads from another part of the body. Psoriatic arthritis is a type of arthritis that often happens with psoriasis. Psoriasis is a skin disease. It causes itchy or sore patches of thick, red skin with silvery scales. There is no cure for most types of arthritis. But arthritis can be slowed and controlled. Medicines can decrease inflammation in the body. Physical therapy can help keep joints affected by arthritis in shape. Splints are commonly used to prevent, slow down or make up for joint deformities. If other treatments are unsuccessful, surgery may be done. Bursitis Bursitis means inflammation of one of your bursa sacs. This inflammation happens in the soft tissue around muscles and bones. It happens most often in the shoulder, elbow, wrist, hip, knee or ankle. A stiff, achy feeling around your joint may be a sign that you have bursitis. If the pain gets worse when you move or press on the joint, you may be experiencing symptoms of bursitis. The area around a joint with bursitis may also look red and swollen. A main cause of bursitis is overusing a joint. You may overuse a joint by doing repetitive tasks. Direct trauma to a joint can also cause bursitis. An example of direct trauma is slamming your knee against the ground during a fall. 3
Your health care provider can treat the common causes of bursitis. Complicated cases may require referral to a specialist, such as an orthopedist or rheumatologist. Treatment focuses on healing the injured bursa. The first step in treating bursitis is to reduce pain and inflammation. Reducing pain and inflammation is done with rest, compression and elevation. Anti-inflammatory medicines such as aspirin, naproxen or ibuprofen can also help. Compression means pressing or squeezing together. In this instance, compression refers to a bandage designed to provide pressure to a specific area. For severe cases of bursitis, you may receive a corticosteroid injection into the area surrounding the inflamed bursa. Corticosteroids are man-made medicines that reduce inflammation. They are similar to hormones that the body naturally produces. Dislocations Dislocations are joint injuries that force the ends of your bones out of position. Dislocations are usually caused by a fall or blow. They can happen from playing a contact sport or being in an accident. Dislocations are very painful. They may cause a joint to look visibly out of place. The joint may look swollen and discolored. You may not be able to move a dislocated joint. Dislocations are an emergency. If you think you or someone you know may have a dislocated joint, see a health care provider right away. Your health care provider will perform a physical examination to help diagnose a dislocation. He or she may order an x-ray or MRI to check for damage to your joint. An MRI, or Magnetic Resonance Imaging scan, uses radio waves and a powerful magnet linked to a computer to create detailed pictures of areas inside the body. 4
Treatment of a dislocated joint depends on the severity of the dislocation. Your health care provider may try to move your bones back into the correct place. This is called reduction. After a reduction, you may be told not to use your joint for a while. This is called immobilization. Splints and slings are used to help with immobilization. Your health care provider may recommend medication to help with pain from a dislocation. This can include anti-inflammatory drugs and muscle relaxants. Physical therapy can help restore the range of motion and strength in a joint. In rare cases, surgery may be necessary to fix blood vessels or nerves damaged by a dislocated bone. Summary A joint is where two or more bones come together. Your joints include the knees, hips, elbows and shoulders. There are many types of joint disorders, including arthritis, bursitis and dislocations. Many joint disorders have similar symptoms. The main symptoms are pain and swelling in or around the affected joint. Arthritis is the most common disease that affects the joints. Arthritis causes the cartilage in a joint to wear away over time. This causes pain and swelling. There are many types of arthritis. Bursitis means inflammation of one of your bursa sacs. This inflammation happens in the soft tissue around muscles and bones. It happens most often in the shoulder, elbow, wrist, hip, knee or ankle. A stiff, achy feeling around your joint may be a sign that you have bursitis. Dislocations are joint injuries that force the ends of your bones out of position. Dislocations are usually caused by a fall or blow. Dislocations are very painful. You may not be able to move a dislocated joint. Treatment for joint disorders depends on the cause and severity of the disorder. Treatments may include medicine, surgery or other treatments. 5