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joint. During this time, protect the injured area and keep it immobile. Do not eat or drink anything, because you may need to have general anesthesia to have the joint repositioned. Don’t let anyone try to manipulate the joint or attempt to reposition it. You could damage nerves or blood vessels or worsen an accompanying injury such as a fracture. A doctor will usually X-ray the joint and surrounding area to make a diagnosis and to evaluate the dislocation.

Treatment

A dislocated joint usually becomes so swollen and painful that repositioning may have to be done with the person under general anesthesia. Sometimes a dislocated joint needs to be repositioned surgically. Your doctor may recommend surgery to tighten the ligaments if one of your joints has become very weak from repeated dislocation.

After repositioning, if the blood vessels, nerves, and bones are in place and undamaged, the joint will probably be immobilized in a brace for 3 to 6 weeks to allow any damaged tissues to heal. Follow your doctor’s instructions about when and how to use your joint again to avoid reinjuring it. After the swelling has subsided, your doctor may recommend exercises to help strengthen the joint.

Ankylosing Spondylitis

Ankylosing spondylitis is a disease that causes inflammation of and damage to the joints, usually the joints of the spine and the hips. After the inflammation subsides, growths of bone called bone spurs gradually develop on each side of the joint and fuse, preventing the joint from moving. The condition occurs most often in men between ages 20 and 40. The cause is unknown.

Symptoms

Ankylosing spondylitis often starts with pain in the lower back that spreads to the buttocks. The pain and stiffness are usually most severe in the morning. Other symptoms include chest pain, difficulty breathing, slight fever, fatigue, jaw pain, and weight loss.The eyes may become red and painful. In some people, a stiff spine makes the head tilt permanently toward the chest.

Inflammation in ankylosing spondylitis

The sacroiliac joints (the joints between the spine and the pelvis) are commonly affected by ankylosing spondylitis, causing stiffness and pain that worsen after rest.

Diagnosis

If you have symptoms of ankylosing spondylitis, your doctor will perform a physical examination. During the examination, the doctor may press on the affected joints to check for pain, move your arms to evaluate the range of motion of your back, and ask you to take a deep breath to see if you have difficulty expanding your chest. He or she may order blood tests and X-rays of your back and hips to confirm a diagnosis of ankylosing spondylitis.

Treatment

Your doctor may prescribe nonsteroidal anti-inflammatory drugs to relieve pain and reduce inflammation. He or she may refer you to a physical therapist, who will teach you how to perform daily activities and exercises that will correct your posture, improve your mobility, and keep your back muscles strong. Exercise and deep breathing will help your chest expand normally. To help keep your spine straight at night, the doctor or physical therapist may also recommend sleeping on a firm mattress without a pillow.

If the inflammation and pain are severe, your doctor may inject a corticosteroid drug into the affected area to reduce inflammation. In severe cases, a doctor may perform a surgical procedure that straightens bent, fused bones by removing some of the damaged bone.

Bursitis

Bursitis is inflammation of a fluid-filled sac (bursa) around a joint. A bursa acts like a cushion to take pressure off the surface of a bone or reduce friction around a tendon or muscle. In bursitis, the bursa becomes inflamed and swollen with excess fluid because it has been damaged or irritated by prolonged pressure, an injury, or repetitive movement. The most common sites for bursitis are the elbows (from leaning or falling on the elbow) and knees (from kneeling for long periods), but the shoulders, hips, and heels also can be affected. Bursitis can also occur as a complication of a deformity of the joint at