Synovitis Case Studies

Progression of osteoarthritis involves of three stages. Stage 1 start from cartilage matrix breakdown follow by cartilage fibrillation and erosion. Disease continues to progress to stage three where synovial inflammation started. With inflamed synovial, synovial membrane produced cytokines, particularly inflammatory cytokines and growth factors which both able to diffuse through synovial fluid and enter the cartilage. This will activates pro-inflammatory cytokines (Pelletier et al, 1999).In short, cartilage breakdown or degrade will lead erosion and release pro-inflammatory cytokine which in turn contribute to joint destruction. In an osteoarthritis knee, Examples of pro-inflammatory cytokines are interleukin-1, IL-1 and tumour necrosis factor alpha, TNF-α.

Stenosing tenosynovitis, or most commonly referred to as trigger finger, is a condition where one of the fingers is stuck in a bent position. The affected finger may straighten in a snap similar to a trigger being pulled and then released. This situation usually occurs when there is inflammation in the area causing space within the sheath surrounding the tendon to become narrow. To help alleviate it, there are home remedies for trigger finger pain.

The patient is 67-year-old gentleman who was discharged from a nursing home 2 days ago after 3 months stay. The patient had a right ruptured quadriceps tendon which was repaired in a Morris Town hospital and he was in the Atrium of Wayne for rehabilitation and discharged home. Since being discharged home he has presented himself three separate times to the emergency room, the final one being on 6/10 here at St. Joseph's where he was admitted. He presented the previous day and he was discharged. The patient presented because his right leg was collapsing while using a walker. CT done in the ED of his right knee shows that he has severe tricompartmental arthritis and loose bones. The patient is in severe pain and he is unable to ambulate. The patient lives alone in his own home. The decision was made that the safest thing was for him to be admitted acutely inpatient to try to sort through the issues that have led up to this point. No arrangements have been made for him to have any outpatient therapy. or any from the Atrium at Wayne. His medical history is significant for having previous cardiac caths. He developed MRSA infection after a quadriceps rupture in Morristown. He has allergic reactions to Metformin (not quite sure what the reaction is). As previously stated he lives alone in a home in Totowa. Physical therapy evaluation reveals the patient is not safe ambulating with a walker and obviously needs intervention. He will need some type of assistive help in the home or long-term care. After much discussion the Atrium agreed to take the patient back while we work through the issues of how he could be cared for in a

James Phillips, a 16 year old, Caucasian male presented to the emergency department with joint pain, loss of appetite, and fatigue. Accompanied by his mother, she said his fever was on and off for the last 1 months and had episode of high grade fever for 3 days in a week. She further explained he has experienced several nose bleeds in the last 3 weeks. Vital signs were taken and Temperature was 100.4˚F, his pulse rate was107 bpm, and blood pressure was 136/68 mmHg. Patient is 5'10" weighing 150 pounds. Mother said patient has lost 10 pounds in 1 month but his routine has not changed. During assessment, pallor was noted, palpable nodules noted in bilateral axillary region, and multiple bruises noted on left and right lower extremities. Patient

is usually a feeling of stiffness, fullness, and pain. The joint swells and may be warm

Osteoarthritis is a type of arthritis that occurs flexible tissue at the end of bones wears down. However us cannot be cured , there are some treatments that may help. This may last for years or even your lifetime. The wearing down of the protective tissue at the end of bones occurs gradually and worsens over time. There is joint pains in the neck , hand , lower part of the back , knee or hips ( most commonly ). Medications , physical therapy and sometimes surgery can help reduce the pain and maintain joint movement. For the diagnoses they may be expected after medical history and medical examination. Or even in joint aspiration. Doctors numbs the area , inserts the needle into the joint to withdraw the fluid. When inserting the needle were

Osteoarthritis is defined as degeneration of articular cartilage witch lead to matrix fibrillation, mild synovitis, gross ulceration, and full thickness lose at the surfaces of the joint. Those changes are combined with hypertrophy of the bone, osteophyte formation at the margin, muscle weakness and thickening and sclerosis of subchondral boney plate by stretching of articular capsule. In the time patients present to the clinic there are also changes of the synovial membrane (produces synovial fluid for lubrication) and inflammatory reactions. The predisposition and etiology of osteoarthritis is due to mechanical, biochemical and genetic factors. (5)

The result of this pain in the joints and in the muscles is often inflammation. The symptoms of this condition closely resemble those of viral flu and sometimes those of arthritis.

There is actually a lot of different knee injuries than we think. A lot of knee injuries actually have a torn ligament and/or cartilage and that can cause the person to rest longer, take Sayers for example, he needed to rest for a bit and do physical therapy to heal it. Another thing is bone spurs, a bone spur is the joint damage associated with osteoarthritis and it can go undetected for years as told on the Mayo Clinic.org.

According to Becker, Daily, & Pohlgeers (2016), acute monoarthritis can be an initial manifestation of many joint diseases. It is arthritis involving an individual joint, which has the clinical presentation of pain and swelling in one joint, similar to Jonathan’s (Becker, Daily, & Pohlgeers, 2016). It is important to urgently and properly diagnose and treat an individual that has certain types of acute monoarthritis, such as septic arthritis to prevent fatality (Thabah, & Chaturvedi, 2014). Acute monoarthritis is diagnosed by Arthrocentesis of the synovial fluid by using culture and crystal analysis (Thabah, & Chaturvedi, 2014). Jonathan’s symptoms started three weeks ago, individuals with acute monoarthritis symptoms are defined as being present for less than two weeks. I would rule out acute monoarthritis as Jonathan’s diagnosis based on Jonathan’s length of knee pain and his afebrile

elbow, knee, wrist and heel, although it can happen anywhere in the body where tendons are

Another way they diagnose the illness is using scanning mechanisms such as X -ray and MRI. NIAMS maintains the fact that x-rays can help Physicians determine what form of arthritis the patient has and how much damage has been done to its health circumstances (NIAMS, 2015). Lastly, Blood tests are another way to diagnose any forms of arthritis. By taking the blood of the patient, doctors are able to determine if what kind of arthritis the patient has and determine if there were other diseases that contributed to the formation of Osteoarthritis.

if you crack your knuckles it just loosens up your fingers.there is a lubricant around your bones and when you crack your knuckled there is a little bubble that pops.

     With school budget cuts, and no music instruments, more and more people are beginning to realize the benefits of having music in education. Providing music as part of education helps develop intelligence that leads to greater success in school and in life. Everyone from VH1 Save The Music to The National Association For Music Education agree that, “Every student in the nation should have an education in the arts.” These two companies are doing everything they can to get out the information about music, and the importance of resorting music education as part of the core curriculum.

According to Burger (2008) “Accounting is the language of business. A lot of people think it 's just numbers, but it 's really a lot more than that. There are a lot of areas outside of numbers that need to be looked at, processes and procedures, what the tone of the company is. Accounting will take you in just about any direction in a company." ~ Wade Becker, CPA, Beard, Miller Co.