Joint Pathology

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  • 0:02 Joint Pain
  • 0:49 Spinal Joint Pathologies
  • 3:48 Other Joint Pathologies
  • 5:14 Arthritis
  • 7:13 Lesson Summary
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Lesson Transcript
Instructor: Betsy Chesnutt

Betsy teaches college physics, biology, and engineering and has a Ph.D. in Biomedical Engineering

Joints in the human body are susceptible to many types of pathology. In this lesson, learn about all the things that can go wrong with your joints and how these pathologies are diagnosed and treated.

Joint Pain

Arthur: Hello! I'm Arthur, and I have been having some pain in my joints. I wonder if there is something wrong with me. Will you go with me to the doctor and help me figure out what is wrong and what I need to do? Great! Thank you!

Doctor: Hello, Arthur! How are you today?

Arthur: I'm not doing so well, doctor. My knees hurt, especially when I first get up in the mornings or when I walk a lot. What do you think is wrong with me?

Doctor: Hmm, there are many things that might cause that. Whenever you have pain, stiffness or swelling in your joints, you might have a problem with your joints that needs treatment. Is it only your knees that hurt, or do you have pain in other joints, too?

Arthur: Well, sometimes my back and my hands hurt, too. Could that be related?

Doctor: Maybe. Let me review all the possible joint pathologies that you might have, and then we can see which one fits your symptoms.

Spinal Joint Pathologies

Doctor: Lower back pain, or lumbago, is very common, affecting about 40% of people during their lifetimes. Since you said your back hurt sometimes, we will start with the joint pathologies that mainly affect the spine. One of the most common spinal joint pathologies is a herniated disc.

A herniated disc occurs when the cartilage disc between your vertebrae becomes compressed and begins to bulge outward. A herniated disc will often press on a nearby nerve and cause pain that radiates from your back down your legs. Does this sound like the type of pain you are having?

Arthur: Not really, doctor. It mostly just hurts in my lower back, but the pain in my knee is much worse.

Doctor: Okay, let's move on to the next type of spinal joint pathology, then. When one vertebrae slips forward and isn't lined up with the one under it, this is called spondylolisthesis. You may hear people call this condition a slipped disc, also. I know it's hard to remember spondylolisthesis, but it may help to think spondylolisthesis means a disc has slipped since both words start with the letter S.

Arthur: Thanks, doctor! That does help!

Doctor: Spondylolisthesis can cause back pain that is achy and feels like a muscle strain. It most commonly occurs in older people due to degeneration of the joints, although it can result from trauma or congenital bone defects as well.

Arthur: That sounds similar to the type of pain I am having, and I did just turn 60, so spondylolisthesis might be what's causing my back to hurt. How is that diagnosed?

Doctor: To know if you have spondylolisthesis or not, you would need to have an X-ray or CT scan to get a picture of the bones inside your spine. There are also some spinal curvature disorders that can cause back pain:

  • Scoliosis is a lateral curve in the spine. This usually occurs in children but can also result from joint degeneration in older adults.
  • Hyperkyphosis occurs when the upper part of the spinal column has too much convex curvature.
  • Hyperlordosis occurs when the lower, or lumbar, region of the spine has excessive concave curvature.

Arthur: Wait a minute, doctor. It sounds to me like you could see these disorders just by looking at my spine. Is that correct?

Doctor: In most cases, yes. Your spine appears straight to me, so it is unlikely that you have any of these conditions. There is one more spinal joint pathology that we should talk about:

Ankylosing spondylitis occurs when there is severe inflammation in the joints of the spine. Eventually this causes new bone to form, which fuses the joints together. It can affect other joints as well but the spine is the most commonly affected area of the body. It causes severe pain and impaired movement, which it doesn't sound like you have right now.

Arthur: No, my back pain isn't that severe, but can you rule that out by doing an X-ray also?

Doctor: Of course!

Arthur: Are the joints in the spine the only ones that can exhibit joint pathology? What about my knees?

Other Joint Pathologies

Doctor: There are other types of joint pathology that can affect joints outside the spine. Some joints are susceptible to dislocation, where one of the bones slips out of place in the joint. The shoulder joint is most commonly dislocated, although other joints can be dislocated as well. Dislocation is the result of some sudden trauma and is extremely painful, so I'm sure that's not your problem.

Arthur: Oh, good! I don't want to have that. How do you treat something like that?

Doctor: Well, actually it's not that difficult. You just have to make sure the bone gets back in the right place, and then, usually, the pain goes away. Bursitis is another possibility. Bursitis is inflammation of the fluid-filled sacs, or bursa, in a joint. It can affect any joint that has a bursa, such as the knee, elbow and shoulder. Elbow bursitis is the most common and can usually be seen as a swelling on the back of the elbow.

Arthur: Well, my elbow doesn't hurt at all, and I don't see any unusual swellings that look like that, so I don't think that's my problem.

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