Impingement

Impingement refers to a medical condition characterized by the compression or pinching of soft tissues, such as tendons or bursae, between bones in a joint. It commonly occurs in the shoulder, although it can also affect other joints in the body, such as the hip or knee.

In the case of shoulder impingement, the tendons and bursae in the shoulder can become compressed or irritated when there is inadequate space between the upper arm bone (humerus) and the acromion, which is part of the shoulder blade (scapula). This can lead to pain, inflammation, and restricted movement.

Causes of shoulder impingement can vary, but some common factors include:

Overuse or repetitive overhead activities: Activities that involve repetitive overhead motions, such as throwing, swimming, or lifting weights, can increase the risk of impingement.


Structural abnormalities: Certain anatomical variations, such as a curved or hooked acromion, may reduce the space available for the tendons to move freely.


Muscle imbalances or weakness: Weakness or imbalances in the muscles around the shoulder joint can affect the stability and proper alignment of the joint, contributing to impingement

Symptoms of shoulder impingement may include:
Pain or tenderness in the shoulder, especially with overhead activities or reaching behind the back.

Limited range of motion or difficulty with certain movements.

Weakness or loss of strength in the affected arm.

Swelling or inflammation around the shoulder joint.

Treatment options for shoulder impingement depend on the severity of the condition but may include:
Rest and activity modification: Avoiding activities that aggravate the symptoms and allowing the shoulder to rest and heal.

Physical therapy: Exercises and stretches to improve shoulder strength, flexibility, and posture.

Pain relief measures: Nonsteroidal anti-inflammatory drugs (NSAIDs), ice packs, or corticosteroid injections to reduce pain and inflammation.

Lifestyle modifications: Adjustments in posture, ergonomics, or technique for sports or activities to reduce strain on the shoulder joint.

Surgical intervention: In severe cases that do not respond to conservative treatments, surgery may be considered to create more space in the shoulder joint or repair damaged tissues.

It's important to consult with a healthcare professional, such as a doctor or physical therapist, for an accurate diagnosis and appropriate treatment plan tailored to your specific condition.

Impingement can refer to various medical conditions where tissues in the body become compressed or pinched, leading to pain, inflammation, and restricted movement. While I provided information specifically about shoulder impingement in my previous response, impingement can occur in other areas of the body as well. Here are a few examples:

Shoulder Impingement: This occurs when the tendons or bursae in the shoulder joint are compressed or irritated, typically due to the narrowing of the space between the upper arm bone and the acromion process of the shoulder blade.


Hip Impingement: Also known as femoroacetabular impingement (FAI), this condition involves abnormal contact between the ball-shaped head of the femur (thigh bone) and the socket (acetabulum) in the hip joint. It can result in pain, limited range of motion, and damage to the hip joint cartilage.


Ankle Impingement: Ankle impingement occurs when there is compression or pinching of soft tissues in the ankle joint, often caused by bony growths or excessive scar tissue. It can lead to pain, swelling, and difficulty with walking or movement.


Spinal Impingement: Spinal impingement, also known as nerve impingement or a pinched nerve, occurs when a nerve root in the spinal column is compressed or irritated. This can result in pain, numbness, tingling, or weakness along the path of the affected nerve.

These are just a few examples of impingement conditions, and there may be others depending on the specific area of the body involved. Treatment options for impingement conditions generally focus on relieving pain, reducing inflammation, improving range of motion, and addressing any underlying causes. It's essential to consult with a healthcare professional for an accurate diagnosis and appropriate treatment plan tailored to your specific situation.

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Bankart repair with remplissage may lower recurrent dislocation rate in Hill-Sachs lesions

Bankart repair with remplissage is a surgical technique used to address recurrent shoulder dislocations in the presence of Hill-Sachs lesions. A Hill-Sachs lesion is a compression fracture of the humeral head that can occur during a shoulder dislocation.

During a Bankart repair, the torn labrum (a ring of cartilage that surrounds the glenoid) is repaired or reattached to the glenoid using sutures. However, in cases where a large Hill-Sachs lesion is present, there is a risk of the humeral head engaging with the glenoid defect and causing recurrent instability.

To address this issue, the remplissage procedure is performed in conjunction with the Bankart repair. In remplissage, the infraspinatus tendon (a muscle in the back of the shoulder) is transferred and placed into the Hill-Sachs defect, effectively filling the defect and creating a barrier to engagement.

This combined approach of Bankart repair with remplissage has been shown to lower the recurrent dislocation rate in cases with significant Hill-Sachs lesions. The presence of remplissage helps prevent engagement of the humeral head in the glenoid defect, reducing the risk of subsequent dislocations.

Several studies have reported positive outcomes with the Bankart repair and remplissage technique, demonstrating improved stability and reduced rates of recurrent dislocation in patients with significant Hill-Sachs lesions.

However, it's important to note that the decision to perform Bankart repair with remplissage depends on various factors, including the size and severity of the Hill-Sachs lesion, patient characteristics, and surgeon expertise. A thorough evaluation by an orthopedic surgeon is necessary to determine the most appropriate surgical approach for each individual case.

In summary, Bankart repair with remplissage is a surgical technique that combines the repair of a torn labrum with the filling of a Hill-Sachs lesion to enhance stability and reduce the risk of recurrent shoulder dislocations. It can be an effective treatment option for patients with significant Hill-Sachs lesions and recurrent instability.

Bankart repair is a surgical procedure performed to address shoulder instability, specifically anterior shoulder instability. It is named after the surgeon who first described the technique, Dr. Arthur Bankart.

Anterior shoulder instability occurs when the humeral head (upper arm bone) dislocates or partially dislocates from the glenoid (shoulder socket) in a forward direction. This can result in recurrent shoulder dislocations and a feeling of instability.

During a Bankart repair, the torn labrum (a ring of cartilage that surrounds the glenoid) is repaired or reattached to the glenoid using sutures. The labrum acts as a stabilizing structure for the shoulder joint, and repairing it helps restore stability and prevent further dislocations.

The surgery is typically performed arthroscopically, using small incisions and a camera (arthroscope) to guide the procedure. The surgeon inserts specialized instruments through additional small incisions to repair the labrum and address any associated soft tissue damage.

Bankart repair is often accompanied by other procedures, depending on the specific condition of the patient's shoulder. These additional procedures may include addressing any capsular laxity (loose ligaments) or addressing other associated injuries such as Hill-Sachs lesions (compression fractures on the humeral head).

Following the surgery, a period of rehabilitation and physical therapy is usually required to restore strength, range of motion, and stability to the shoulder joint. The length and intensity of the rehabilitation process will vary depending on the individual and the extent of the initial injury.

Bankart repair is considered a successful surgical intervention for anterior shoulder instability, with a high rate of returning patients to their pre-injury level of activity and reducing the risk of recurrent dislocations. However, the success of the surgery can depend on various factors, including the severity of the initial injury, patient compliance with rehabilitation, and the surgeon's skill and experience.

It is important for individuals considering Bankart repair or any surgical procedure to consult with an orthopedic surgeon who can provide a thorough evaluation and determine the most appropriate treatment plan based on their specific condition.

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Nonrigid fixation may yield higher failure rates after arthroscopic glenoid reconstruction

Nonrigid fixation in arthroscopic glenoid reconstruction refers to the use of techniques that do not provide rigid stability or secure fixation of the glenoid bone. This can include methods such as suture anchors or soft tissue grafts.

Several studies and research have suggested that nonrigid fixation in arthroscopic glenoid reconstruction may result in higher failure rates compared to rigid fixation techniques. Failure in this context refers to recurrent instability or inadequate healing of the reconstructed glenoid.

One reason for the higher failure rates with nonrigid fixation is the potential for insufficient initial stability of the reconstructed glenoid. Without rigid fixation, there is a greater likelihood of graft or anchor loosening, leading to recurrent instability or graft failure.

Rigid fixation techniques, on the other hand, provide more secure and stable fixation of the glenoid, allowing for better healing and reduced risk of recurrent instability. These techniques typically involve the use of screws or other hardware to secure the bone graft or anchor in place.

It's important to note that the choice of fixation technique in arthroscopic glenoid reconstruction depends on various factors, including the patient's specific condition, surgeon expertise, and other anatomical considerations. The decision should be made based on a thorough evaluation of the individual case.

Overall, while nonrigid fixation techniques may have some advantages in certain cases, they should be used cautiously, and the potential for higher failure rates should be carefully considered and discussed with the surgeon. Rigid fixation techniques generally remain the gold standard for achieving long-term stability and successful outcomes in arthroscopic glenoid reconstruction.

Nonrigid fixation refers to the use of techniques that do not provide rigid stability in arthroscopic glenoid reconstruction, a surgical procedure used to repair and stabilize the glenoid (shoulder socket). Instead of using rigid hardware like screws, nonrigid fixation methods utilize sutures or soft tissue grafts to secure the glenoid.

Recent research suggests that nonrigid fixation may lead to higher failure rates compared to rigid fixation techniques. Failure in this context refers to recurrent instability or inadequate healing of the reconstructed glenoid.

One of the reasons behind the higher failure rates associated with nonrigid fixation is the potential for inadequate initial stability. The absence of rigid fixation can result in increased movement or loosening of the graft or anchor, leading to instability and compromised healing.

Rigid fixation techniques, such as the use of screws or other hardware, offer more secure and stable fixation of the glenoid. This allows for better healing and reduces the risk of recurrent instability or graft failure.

It's essential to note that the choice between rigid and nonrigid fixation depends on various factors, including the specific case, patient characteristics, and surgeon preference. There may be situations where nonrigid fixation is appropriate, such as in certain anatomical variations or cases where rigid fixation is not feasible.

The decision on which fixation technique to use should be made on a case-by-case basis, considering factors such as the patient's condition, surgeon expertise, and the desired outcome. It is important for patients to have a thorough discussion with their orthopedic surgeon to understand the pros, cons, and potential risks associated with both rigid and nonrigid fixation options.

In summary, while nonrigid fixation techniques have certain advantages, such as versatility and potential for less invasive surgery, they may carry a higher risk of failure compared to rigid fixation methods. Surgeons carefully evaluate each case to determine the most appropriate fixation technique that will provide optimal stability and long-term success for arthroscopic glenoid reconstruction.

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Bone and joint infections

In this educational video, we delve into the world of bone and joint infections. From common conditions like osteomyelitis to septic arthritis, we explore the causes, symptoms, diagnosis, and treatment options for these musculoskeletal infections. Join us as we discuss the latest advancements in orthopedic infectious disease management, highlighting both surgical and non-surgical approaches. Stay informed and gain valuable insights into how healthcare professionals handle bone and joint infections.

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Bone & Joint Infections

If bacteria enter the body, they can find their way to the musculoskeletal system, leading to infection. Bone and joint infections, also known as musculoskeletal infections, occur most commonly in toddlers and young children. They often occur in the bones and joints of the arms and legs. An infection of the bone is called osteomyelitis and septic arthritis refers to a joint infection.
Bone and joint infections are usually caused by bacteria called Staphylococcus aureus (or “staph”) and require treatment with antibiotics. A serious form of staph known as methicillin-resistant Staphylococcus aureus (MRSA) causes infections that can be more severe and need special antibiotics to treat.

It is important to recognize and treat bone and joint infections because they can:


Spread to the blood and other organs causing life-threatening illness
Damage growth plates, bones and joints
Cause chronic arthritis and bone fractures

Symptoms of bone and joint infections may include:

Pain (localized or vague) in a limb or joint that increases in severity
Pain with bearing weight on the affected limb or joint
Pain with touching the affected area
Redness and swelling at the site of pain
Redness and swelling of the joint
Warmth and redness in the infected area
Fever
Fatigue
General malaise

Diagnosis of Bone & Joint Infections

Pediatric infectious disease specialists at Riley at IU Health diagnose children with symptoms of an infection using the following tests:

Physical exam. This is a routine test that doctors use to assess health.
Blood test. This test examines a sample of blood.
X-ray. This test produces images of the inside of the body to help identify possible areas of infection.
Computed tomography (CT). This special X-ray produces cross-sectional images of the body to see if certain areas of the body are infected.
Magnetic resonance imaging (MRI). This test produces images of the inside of the body to see if there is inflammation in the infected areas. Some children may need diagnostic and interventional anesthesia for this test.

Once an experienced pediatrician or pediatric orthopedist determines that your child has a bone or joint infection, a procedure may be required to obtain a sample from the infected area. In the case of joint infections, fluid is aspirated using a needle and sent for laboratory analysis. Infections of the bone may require a bone biopsy (tissue sample taken from the body and examined) to help identify what specific bacteria have infected the bone. These procedures help decide the appropriate antibiotic for that type of bacterial infection. Occasionally, orthopedic surgery is required in cases of complicated musculoskeletal infections.

Treatments

If your child has a bone or joint infection, he or she needs to be treated by an experienced pediatric infectious disease specialist as well as a pediatric orthopedic surgeon. If infections are identified and treated early, most children have a good outcome.

Bone and joint infections are treated with intravenous (IV) antibiotics during a short hospital stay. After leaving the hospital, most children take oral antibiotics, usually for several weeks.

Some children may need a special IV called a peripherally inserted central catheter (PICC) line. A PICC line provides intravenous access for a prolonged period of time so the child can continue to receive IV antibiotics at home.

Treatment should include follow-up with a pediatric infectious disease specialist and a pediatric orthopedist.


Bone and joint infections, also known as musculoskeletal infections, occur most commonly in toddlers and young children.
Bone and joint infections are usually caused by bacteria called Staphylococcus aureus (or “staph”) and require treatment with antibiotics.
When treated early, most children with bone and joint infections have a positive outcome.
Some complicated cases of musculoskeletal infections may require orthopedic surgery.

Support Services & Resources

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Bone & Joint Infections Research

The Infectious Diseases Department and the Radiology & Imaging Department at Riley at IU Health are conducting research on the most effective diagnostic methods for musculoskeletal infections.


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Surgery for scoliosis

Scoliosis is a condition that causes the spine to curve to the side, resulting in an abnormal posture and sometimes causing discomfort or difficulty breathing. While some cases of scoliosis can be managed through non-surgical means such as bracing or physical therapy, others may require surgery to correct the curvature of the spine.

Surgery for scoliosis typically involves a procedure called spinal fusion, which aims to fuse the affected vertebrae together so that they can no longer move independently. During the surgery, the surgeon will use metal rods, screws, and other devices to straighten the spine and hold it in place while the bones fuse together over time.

Spinal fusion surgery for scoliosis is a complex procedure that carries some risks, including infection, bleeding, and nerve damage. However, for many people with severe scoliosis, surgery can be an effective way to improve their quality of life and prevent further progression of the condition.

Recovery from scoliosis surgery can be lengthy and may involve a period of immobilization or limited activity. Physical therapy and rehabilitation are often recommended to help restore mobility and strength in the affected area. Your doctor will work with you to develop a personalized treatment plan based on your individual needs and the severity of your scoliosis.


Surgery for scoliosis is usually recommended when the curvature of the spine is severe (typically greater than 40-50 degrees), causing significant pain or discomfort, or interfering with daily activities such as breathing or walking.


The goal of scoliosis surgery is to correct the curvature of the spine and prevent further progression of the condition. This is typically achieved through spinal fusion, which involves fusing together the affected vertebrae using metal rods, screws, or other devices.


Recovery from scoliosis surgery can be lengthy and may involve a period of immobilization or limited activity. Physical therapy and rehabilitation are often recommended to help restore mobility and strength in the affected area.

Types of scoliosis surgery:

Posterior spinal fusion: This is the most common type of scoliosis surgery, in which the surgeon makes an incision in the back and uses metal rods, screws, and other devices to straighten the spine and hold it in place while the bones fuse together.


Anterior spinal fusion: In this type of surgery, the surgeon makes an incision in the front of the body and removes a rib to access the spine. Metal devices are used to straighten the spine and hold it in place while the bones fuse together.


Thoracoscopic surgery: This is a minimally invasive type of surgery in which the surgeon makes several small incisions in the back and uses a tiny camera and specialized instruments to perform the spinal fusion.


Vertebral body tethering: This is a newer type of surgery that involves attaching a flexible cord to the affected vertebrae to correct the curvature of the spine. Unlike spinal fusion, this procedure allows for some movement in the spine.

It's important to note that the type of surgery recommended for scoliosis will depend on the individual's age, the severity and location of the curvature, and other factors. Your doctor will work with you to determine the best course of treatment based on your individual needs.

Scoliosis surgery is a procedure that can help correct the curvature of the spine in people with severe cases of scoliosis. Spinal fusion is the most common type of surgery for scoliosis, which involves fusing together the affected vertebrae using metal rods, screws, or other devices. Recovery from scoliosis surgery can be lengthy and may involve a period of immobilization or limited activity. Physical therapy and rehabilitation are often recommended to help restore mobility and strength in the affected area.

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What is fracture.

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A fracture is a medical condition where a bone is broken. It can be caused by accidents, falls, or repetitive stress on the bone. Symptoms include pain, swelling, and difficulty moving the affected area. Treatment options depend on the severity of the fracture, and may include immobilization with a cast or brace, surgery, pain management, and physical therapy.


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Knee Arthroplasty and surgerying

Knee arthroplasty, also known as knee replacement surgery, is a surgical procedure in which a damaged or diseased knee joint is replaced with an artificial joint. Knee arthroplasty is typically performed on patients who have severe knee pain or limited mobility due to conditions such as osteoarthritis, rheumatoid arthritis, or injury.


During knee arthroplasty, the surgeon removes the damaged portion of the knee joint and replaces it with a prosthetic joint made of metal, plastic, or ceramic materials. The prosthetic joint is designed to mimic the natural movement and function of the knee joint, allowing patients to regain mobility and reduce pain.

There are several types of knee arthroplasty, including total knee replacement, partial knee replacement, and revision knee replacement. The type of arthroplasty used depends on the severity and location of the damage to the knee joint.

Knee arthroplasty is typically performed under general anesthesia and requires a hospital stay of a few days. Physical therapy and rehabilitation are typically required to help patients regain strength and mobility in the affected knee.

Knee arthroplasty is generally considered a safe and effective procedure, but as with any surgery, there are risks involved. These may include infection, bleeding, nerve damage, blood clots, and anesthesia-related complications. Patients should talk to their doctor about the risks and benefits of knee arthroplasty, and what to expect during and after the procedure.

  

Knee arthroplasty, also known as knee replacement surgery, is a surgical procedure used to treat severe knee pain and limited mobility caused by conditions such as osteoarthritis, rheumatoid arthritis, or injury. During knee arthroplasty surgery, the surgeon replaces the damaged portion of the knee joint with an artificial joint made of metal, plastic, or ceramic materials.

The knee arthroplasty surgery procedure typically involves the following steps:

* Anesthesia: The patient is given anesthesia, which can be general anesthesia or a regional nerve block.


* Incision: The surgeon makes a large incision near the knee joint.


* Preparation: The surgeon removes the damaged portion of the knee joint and prepares the remaining bone for the implant.


* Implant: The artificial joint is implanted into the knee joint and secured in place with cement or other materials.


* Closing the incision: Once the surgery is complete, the incision is closed with sutures or steri-strips.

Knee arthroplasty surgery is generally considered a safe and effective procedure, but as with any surgery, there are risks involved. These may include infection, bleeding, nerve damage, blood clots, and anesthesia-related complications. Patients should talk to their doctor about the risks and benefits of knee arthroplasty surgery, and what to expect during and after the procedure.

Recovery time varies depending on the type of knee arthroplasty surgery and the severity of the condition being treated, but most patients can return to normal activities within a few weeks to a few months after surgery. Physical therapy and rehabilitation are typically required to help patients regain strength and mobility in the affected knee.

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Arthroscopy and Arthroscopy surgery

Arthroscopy is a minimally invasive surgical technique that allows doctors to view and treat problems inside a joint using a specialized tool called an arthroscope. An arthroscope is a small camera that is inserted into the joint through a small incision. The camera provides a clear view of the joint on a monitor, allowing the doctor to see any damage or problems inside the joint.

Arthroscopy is commonly used to diagnose and treat problems in the knee, shoulder, hip, ankle, elbow, and wrist. It can be used to treat a wide range of conditions, including torn cartilage, torn ligaments, joint infections, joint inflammation, and bone spurs.

During the arthroscopic procedure, the surgeon will make a small incision near the joint and insert the arthroscope. They will then examine the joint and use small surgical instruments to make any necessary repairs or remove any damaged tissue. The procedure is typically performed under general anesthesia, and most patients can go home on the same day.

One of the advantages of arthroscopy is that it is minimally invasive, which means that it causes less damage to the surrounding tissue than traditional open surgery. This can result in less pain, a faster recovery time, and a lower risk of complications. However, not all joint problems can be treated with arthroscopy, and in some cases, open surgery may be necessary.

Arthroscopy is generally considered a safe and effective procedure, but as with any surgery, there are risks involved. These may include infection, bleeding, nerve damage, and anesthesia-related complications. Patients should talk to their doctor about the risks and benefits of arthroscopy, and what to expect during and after the procedure.

Arthroscopy surgery is a minimally invasive surgical procedure used to diagnose and treat problems in the joints. It involves the use of a small, specialized tool called an arthroscope, which is inserted into the joint through a small incision. The arthroscope contains a camera that provides a clear view of the joint on a monitor, allowing the surgeon to see any damage or problems inside the joint.

Arthroscopy surgery is commonly used to diagnose and treat problems in the knee, shoulder, hip, ankle, elbow, and wrist. It can be used to treat a wide range of conditions, including torn cartilage, torn ligaments, joint infections, joint inflammation, and bone spurs.

The arthroscopy surgery procedure typically involves the following steps:

* Anesthesia: The patient is given anesthesia, which can be general anesthesia or a regional nerve block.


* Incision: The surgeon makes a small incision near the joint.


* Arthroscopy: The arthroscope is inserted into the joint through the incision.


* Diagnosis: The surgeon examines the joint and uses the camera to identify any problems.


* Treatment: The surgeon may use small surgical instruments to make repairs or remove any damaged tissue.


* Closing the incision: Once the surgery is complete, the incision is closed with sutures or steri-strips.

Arthroscopy surgery is generally considered a safe and effective procedure, but as with any surgery, there are risks involved. These may include infection, bleeding, nerve damage, and anesthesia-related complications. Patients should talk to their doctor about the risks and benefits of arthroscopy surgery, and what to expect during and after the procedure. Recovery time varies depending on the type of arthroscopy surgery and the severity of the condition being treated, but most patients can return to normal activities within a few weeks to a few months after surgery.

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Joint disorders

Joint disorders refer to a wide range of conditions that affect the joints, which are the parts of the body where two or more bones come together. Joints are responsible for facilitating movement and supporting the weight of the body.

Some common joint disorders include osteoarthritis, rheumatoid arthritis, gout, and juvenile idiopathic arthritis. Osteoarthritis is a degenerative condition that occurs when the cartilage that cushions the joints wears down over time, leading to pain and stiffness. Rheumatoid arthritis is an autoimmune disorder that causes inflammation and pain in the joints, as well as other parts of the body. Gout is a type of arthritis that occurs when uric acid crystals build up in the joints, leading to swelling and pain. Juvenile idiopathic arthritis is a type of arthritis that affects children and can cause joint pain, stiffness, and swelling.

Other joint disorders include bursitis, tendinitis, carpal tunnel syndrome, and frozen shoulder. Bursitis is a condition that occurs when the small fluid-filled sacs that cushion the joints become inflamed, causing pain and stiffness. Tendinitis is a condition that occurs when the tendons that attach muscles to bones become inflamed, causing pain and stiffness. Carpal tunnel syndrome is a condition that occurs when the median nerve in the wrist is compressed, causing pain, numbness, and tingling in the hand and fingers. Frozen shoulder is a condition that occurs when the capsule of connective tissue surrounding the shoulder joint becomes inflamed and stiff, causing pain and restricted movement.

Treatment options for joint disorders vary depending on the type and severity of the condition, but may include rest, physical therapy, medication, or surgery. Management of joint disorders often involves a multidisciplinary approach, with healthcare providers such as rheumatologists, orthopedic surgeons, physical therapists, and occupational therapists working together to provide comprehensive care.

Here are some of the most common joint disorders:

* Osteoarthritis: This is the most common type of joint disorder, affecting millions of people worldwide. It occurs when the cartilage that cushions the joints wears down over time, leading to pain and stiffness.


* Rheumatoid arthritis: This is an autoimmune disorder that causes inflammation and pain in the joints, as well as other parts of the body. It affects about 1% of the population and is more common in women than men.


* Gout: This is a type of arthritis that occurs when uric acid crystals build up in the joints, leading to swelling and pain. It typically affects the big toe, but can also affect other joints in the body.


* Bursitis: This is a condition that occurs when the small fluid-filled sacs that cushion the joints become inflamed, causing pain and stiffness.


* Tendinitis: This is a condition that occurs when the tendons that attach muscles to bones become inflamed, causing pain and stiffness.


* Carpal tunnel syndrome: This is a condition that occurs when the median nerve in the wrist is compressed, causing pain, numbness, and tingling in the hand and fingers.


* Frozen shoulder: This is a condition that occurs when the capsule of connective tissue surrounding the shoulder joint becomes inflamed and stiff, causing pain and restricted movement.


* Juvenile idiopathic arthritis: This is a type of arthritis that affects children and can cause joint pain, stiffness, and swelling.


* Ankylosing spondylitis: This is a type of arthritis that primarily affects the spine, causing inflammation and stiffness.


* Psoriatic arthritis: This is a type of arthritis that occurs in people with psoriasis, a skin condition. It causes joint pain, stiffness, and swelling, as well as skin lesions.

These are just some of the many types of joint disorders that can affect the body. Treatment options vary depending on the type and severity of the condition, but may include rest, physical therapy, medication, or surgery.

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The hand and upper extremity

The hand and upper extremity refer to the parts of the body including the hand, wrist, forearm, elbow, upper arm, and shoulder. These structures are important for many daily activities, such as reaching, grasping, lifting, and carrying objects, as well as for more complex tasks that require fine motor skills, such as writing, drawing, and playing musical instruments.

In medicine, the hand and upper extremity are often studied as a separate specialty within orthopedic surgery or plastic surgery. Physicians who specialize in this area may diagnose and treat a wide range of conditions, injuries, and diseases that affect the hand and upper extremity, such as fractures, dislocations, nerve injuries, tendon injuries, arthritis, and congenital deformities. Treatment options may include surgery, medication, physical therapy, occupational therapy, and other forms of rehabilitation and support.


The hand and upper extremity are parts of the body that include the hand, wrist, forearm, elbow, upper arm, and shoulder. They are important for performing many everyday activities and tasks that require fine motor skills and strength.

The hand consists of 27 bones, and its intricate structure allows for a wide range of movements and functions. The wrist is composed of eight small bones that connect the hand to the forearm, and it is responsible for flexion, extension, and rotation of the hand. The forearm contains two bones, the radius and the ulna, that allow for supination and pronation of the hand.

The elbow is a hinge joint that connects the forearm to the upper arm and allows for flexion and extension of the arm. The upper arm consists of the humerus bone, which connects to the shoulder blade and allows for movements such as abduction, adduction, and rotation of the arm. The shoulder is a complex joint that connects the upper arm to the rest of the body and allows for a wide range of movements, including flexion, extension, abduction, adduction, and rotation.

Injuries and conditions that affect the hand and upper extremity can range from minor sprains and strains to severe fractures, dislocations, and nerve injuries. Treatment options depend on the severity and nature of the injury or condition and may include rest, physical therapy, medication, surgery, or a combination of these approaches.


The hand and upper extremity are essential parts of the body responsible for performing many complex movements and activities.

The hand is composed of bones, muscles, tendons, and ligaments that work together to provide a wide range of functions, such as grasping, gripping, and manipulating objects with precision. It also contains sensory receptors that allow us to feel textures, temperatures, and pain.

The wrist joint is located between the hand and the forearm and is responsible for allowing flexion, extension, adduction, and abduction movements of the hand. The forearm contains two long bones called the radius and ulna, which work together to allow rotation of the wrist and hand.

The elbow joint connects the upper arm bone (humerus) to the two forearm bones (radius and ulna) and is responsible for flexion and extension movements of the arm. The shoulder joint is a ball-and-socket joint that connects the upper arm bone to the shoulder blade and allows for a wide range of movements, including abduction, adduction, flexion, extension, and rotation of the arm.

Injuries and conditions that affect the hand and upper extremity can range from minor sprains and strains to severe fractures, dislocations, and nerve injuries. Treatment options depend on the nature and severity of the injury or condition and may include rest, immobilization, physical therapy, medication, or surgery.

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Types of Bone & Joint Infections

NYU Langone physicians are experienced in identifying and treating bone infections, known as osteomyelitis, and joint infections, or septic arthritis. These infections begin when disease-carrying bacteria enter the body, often after a trauma or a surgical procedure, and spread to the bones and joints through the bloodstream. Without prompt treatment, bone and joint infections can become long-term conditions.

Osteomyelitis

Osteomyelitis often occurs when an infection elsewhere in the body, such as a urinary tract infection or pneumonia, spreads through the blood to the bones. Sometimes, a recent surgery, an injection around a bone, or an open fracture—when a bone punctures the skin—can expose bone to bacteria, causing osteomyelitis.

An open wound over a bone can also lead to osteomyelitis. This condition is most common in people who have diabetes and diabetic foot ulcers. It also can develop in people who have peripheral neuropathy, in which nerve damage makes it difficult to detect an injury in the limbs.

Initially, osteomyelitis develops rapidly and is usually accompanied by pain, fever, and stiffness. Chronic osteomyelitis progresses slowly and may be the result of a previous bone infection. Despite multiple courses of antibiotics, the condition may return if the bacteria causing the infection become resistant to antibiotics. Symptoms of chronic osteomyelitis may include fever, pain, and redness or discharge at the site of the infection.

Adults are more likely to develop osteomyelitis in the vertebrae—the bones of the spine—or in a part of the body where they’ve previously had surgery for a fracture or had joint replacement.

Adults tend to develop chronic symptoms, such as pain at the site of injury or surgery. They may also experience tenderness, swelling, warmth, or redness over the affected bone. People with diabetes or peripheral neuropathy may not have pain or a fever, but they may notice that an injured area of skin, such as a foot ulcer, is not healing.

In children, osteomyelitis usually affects the long bones in the legs and upper arms, including the femur and the humerus. Symptoms may include fever, chills, redness at the site of infection, pain or tenderness over the affected bone, and difficulty using the affected limb. They may, for instance, have trouble walking due to severe pain in the legs.

Septic Arthritis

Septic arthritis is the inflammation of a joint due to a bacterial or fungal infection. The condition occurs when a penetrating injury, such as a puncture wound, occurs near or above a joint, allowing bacteria to directly enter the joint. Bacteria can also spread through the bloodstream to a joint from a recent infection or after surgery.

It often affects the joints near long bones in the legs and arms. These include the hip, knee, and ankle joints and the shoulder, elbow, and wrist joints. The infection can also occur in the spine, pelvis, and heels.

Infants and older adults are most vulnerable to septic arthritis due to their anatomy and blood supply to the joints. The knee and hip are the most commonly affected joints in adults, whereas the hip is the most common site of infection in infants.

Septic arthritis can quickly cause severe damage to the cartilage and bone within a joint. Prompt treatment is critical for preventing permanent joint damage.

Symptoms are usually severe and include fever, redness, and swelling at the joint and intense pain that worsens with movement. In infants, symptoms may include a fever, the inability to move the limb with the infected joint, and crying when the infected joint is moved. For instance, infants with septic arthritis in a hip joint may cry when having a diaper change.

Our Research and Education in Bone and Joint Infections


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What is Joint Disorders

What are joints?

Your joints are places where two or more bones come together. Your shoulders, elbows, hips, knees, and knuckles are all joints. Your spine has joints, too.

But joints are more than bones. They include the soft tissues around them, such as cartilage, tendons and ligaments. Cartilage is the hard slippery flexible tissue that covers the ends of your bones at a joint. Tendons are tough, flexible bands that connect your muscles to your bones so you can move your joints. Ligaments connect the bones of the joint to each other to keep them stable when you move.

What are joint disorders?

Joint disorders are diseases or injuries that affect your joints. Injuries can happen because of overuse of a joint. Or you could have a sudden injury, such as an accident or a sports injury.

What diseases can affect the joints?

Many diseases can affect the joints. They often cause joint pain and make your joints stiff, red, or swollen. Most of them are chronic. That means they last a long time. Some may never go away completely. Some of the diseases that affect the joints include:Arthritis. Arthritis may cause joint pain and swelling. There are many types of this disease. Osteoarthritis is the most common type. Over time, arthritis can cause severe joint damage. It can affect people of all ages. A joint injury when you're young may cause osteoarthritis later in life.
Lupus. This autoimmune disease affects many parts of the body and can cause joint and muscle pain. Some types of lupus often cause arthritis.
Sjögren's Syndrome. This autoimmune disease affects glands that make moisture in many parts of the body. The main symptoms are dry eyes and mouth, but it often causes joint pain, too.

Treatments are different depending on the disease. But most treatments include medicines and therapies to relieve pain and other symptoms.

What types of joint disorders happen from sudden injuries?

Joint disorders from sudden injuries include:Sprains and strains. Sprains are stretched or torn ligaments. Acute strains are stretched or torn muscles or tendons that happen from a sudden injury or movement, such as lifting a heavy object.
Dislocated joints. A joint is dislocated when the bones are pushed or pulled out of position. A joint dislocation is a medical emergency.

Treatment depends on the type of injury. You can treat many sports injuries at home. But you should call your health care provider if you:Have a lot of joint pain, swelling or numbness
Can't put weight on the joint
Have pain from an old injury with more swelling, an unstable joint, or a joint that isn't normal in another way

What types of joint disorders happen from overuse?

Overuse injuries usually damage the soft tissues of the joint. They can happen when you work a joint too hard by doing the same movements over and over. For example, you could get an overuse injury from playing a musical instrument, playing sports, or doing certain jobs, such as carpentry or painting.

Joint overuse injuries include:Bursitis. The bursa is a small fluid-filled sac. It works as a pad between the bones of a joint and the moving parts around it, such as muscles, tendons and skin. With bursitis, the bursa becomes irritated and swollen with extra fluid. Overuse is the most common cause, but injuries, infections and other conditions, such as arthritis, can cause bursitis.
Tendinitis. This condition happens when you overuse a tendon. It swells and makes the joint painful to move.
Chronic strain. A strain becomes chronic when your muscles or tendons stretch or tear slowly over time from repeating the same movements.

The treatments for bursitis, tendinitis, and chronic strain are often the same. They usually include rest, keeping the injured joint higher than your heart, and taking medicine to reduce swelling. Your provider may recommend gentle exercise and other treatment. In some cases, your provider may suggest an injection (a shot) of medicine into the joint. If these do not help, you may need surgery.

How can I keep my joints healthy?

Getting enough physical activity is one of the most important things you can do to prevent or slow joint disorders. Activity strengthens the muscles around your joints and helps them work better.

When you play sports, wear the right equipment to protect your joints, such as knee pads. If you already have joint problems, ask your provider what type of activities are best for you.

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