We're going to talk a little bit about traumas and diseases and disorders that can occur at joints. So a common one is bursitis. This is going to be inflammation of the bursa. This can happen at pretty much any joint that has bursa in it. It can be caused by bacterial, viral, it could be that you tore part of the fibrous sac, it could be that the synovial fluid is not functioning correctly.
So we can see that a normal bursa is relatively small. And it's basically going to stop the friction between ligaments that go around the olecranon and the bursa. And here we can see that this bursa is inflamed. So when you have an inflamed bursa within the olecranon, it's going to end up looking something like this.
Depending on the cause of the bursitis, we'll tell you how you're going to treat it. but it is going to be inflamed, swollen, pretty painful, and it could affect movement at joints. Next are the menisci. These are the fibrocartilage discs that are found between the tibia and the femur. Remember, the femur has that rounded end.
The tibia has almost a flat top. So these menisci, where they're curved right here, helps that rounded femur end, the condyles, fit better into the flattened condyle or surface of the tibia. So these are healthy menisci right here, what we're seeing.
Okay, here's a drawing of healthy menisci. And then here what we're seeing is a full tear. You can kind of see it looks like shreds going on.
So these are all the collagen fibers of the fiber cartilage. And then here it's really smooth, but then you can see a partial tear right there. For menisci tear, you can undergo surgery to repair it. Oftentimes that is a way to fix it relatively quickly. Or you can take the chance and let it heal on its own.
But remember, cartilage does not have a blood supply and then fibrocartilage lacks a perichondrium where the blood supply usually comes from. Next are arthritis, basically inflammation of joints. There are 50 plus types of arthritis.
So we're only going to talk about the ones that people are most familiar with or have heard of. Now what I want you to notice in a normal joint, what we have is we have a nice space between the two articulating bones. We have our synovial membrane and our fibrous membrane intact and we have our articular cartilage intact.
In osteoarthritis, this is known as wear and tear arthritis. You can see that we have lost the space right here. and that the bones are actually touching and you're not even seeing articular cartilage on the end of this bone or in the concave portion of this bone.
And then in rheumatoid arthritis, the bones aren't quite touching yet but there's definitely not as much room between them and we see redness which usually indicates inflammation. We also see that the fibrous membrane has decreased in its thickness. So in osteoarthritis, also known as wear and tear, What is happening is it's a degradation of articular cartilage. Because the articular cartilage is degrading, we're no longer having that smooth movement of the two bones over each other.
And when that happens, the two bones start to rub against each other, which actually tears away at the cartilage. And your body, in reaction to that, will start to create bone spurs. to create more surface area between the bones because it thinks it's helping but what it's doing is it's creating actually more friction.
So here is a defect in articular cartilage. We can see that most of the cartilage is pretty much gone. It's down to the bone but we're not quite seeing the bone whereas here we can see that it's already torn through all of the cartilage down into the surface of the bone.
So there are ways to repair this and treat it. Most osteoarthritis is going to be treated through different types of therapy. Surgery usually is a last resort due to the fact that cartilage does not grow very easily. However, there is a way to actually implant cartilage cells if you're a candidate.
So what doctors will do is they'll take healthy cartilage cells from articular cartilage that's still intact within that joint. So doctors could take it from up here, they could take it from the tibia articular cartilage, from healthy femoral articular cartilage. Then they're going to grow that cartilage in a culture dish.
for about a month, a month and a half. And hopefully these cartilage cells will be healthy enough to repair the area. Once enough cells are grown, the doctors will actually remove any damaged cartilage to have a clean starting area.
So if you've ever had a wound and you didn't get it stitched up fast enough, the skin around the wound starts to die necrosis and they'll end up cutting away the dead skin to have fresh skin to sew together. So the surgeon will remove that damaged areas till we have a new area to work in. They're going to take a piece of the periosteum from the tibia, place that patch over the cartilage patch, make sure it's secured with a fiber and glue, and then they're going to implant cartilage cells under the patch. This way, the cells are isolated in a relatively clean, sterile area, and they will have nutrients, hopefully, that will be able to... diffuse into the area for growth and this will help promote cartilage growth, cartilage cell growth over time.
Again, this is not a surefire way, but if you are a candidate, it is an option. So here we can see that we're down to bone and then we can see that they're putting a piece of periosteum over that area down to bone. Last is rheumatoid arthritis. or not last, but the next one is rheumatoid arthritis. This is an autoimmune disease that doesn't attack the cartilage per se.
It attacks the synovial membranes of the joint. So it's actually attacking the synovial cavities and it causes them to be really inflamed and actually degrades the membranes. When those membranes start to be degraded, the joint cavity is no longer separated and the bones will start to touch together. When this happens, then we have wear and tear of the articular cartilage, but that's a secondary effect, not the primary. Rheumatoid arthritis is that autoimmune disease that usually will show up between 40 and 60 years of age.
However, it can be seen at any age in an individual, even children. Women are going to be more susceptible to the disorder. They're not exactly sure what causes it, but there are genetic factors. There are genes in women that will predispose them to being more susceptible to the order, whether it's the bacterial or viral that initiates the onset. Now, the treatments will always be tailored to the individual.
And what's unique about rheumatoid arthritis is it's a symmetrical disease, meaning that if it attacks your right hand, it'll attack your left hand. If it attacks your right knee, it'll attack your left knee. Over time, the worst, the...
joint cavities get, the bones will begin to touch and they will basically degrade each other and could lead to fusion. So this is just a picture of showing you early, intermediate, and late. We can see that these bones are overlapping each other right here and we often call these swan fingers because they kind of have like a swan neck.
The last type of arthritis that's often seen in individuals is called gout or gouty arthritis. This, again, can be a genetic predisposition to it, but is also often caused by diet. So what happens is most of the time you see it in the big toe.
That's the joint that's mostly affected, but you can also see it in your hand joints, specifically your thumb. Uric crystals, uric acid crystals, or sodium urate crystals, will actually be deposited in the joint. So you can see that these are little sharp crystals right here that will deposit themselves within the joint cavity.
With those little sharp crystals, they start to erode away at the fibrous membrane, at the articular cartilage, which will cause your bone to start to develop spurs or react violently against it. What happens is you have inflammation, swelling. It's extremely painful, almost debilitating with your mobility.
Treatments for it will be medicine as well as a change in diet. People that have gout often have high levels of purines. And purines are one of those nitrogen bases that we find in your DNA. So lots of processed foods have high amounts of purines. And if you get too much in your body, your body cannot break them down.
So we end up having higher amounts of your acid crystals in your bloodstream. Again, you can be predisposed to this, so knowing family history is always important.