Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
A bursa is a closed
fluid-filled sac that functions as a gliding surface to reduce friction between
tissues of the body. Bursae is plural for bursa. The major bursae are located adjacent to
the tendons near the large joints, such as the shoulders, elbows, hips, and
knees. When a bursa becomes inflamed, the condition is known as bursitis.
Most commonly, bursitis is caused by local soft tissue trauma or strain injury, and there is no
infection (aseptic bursitis). On rare
occasions, the bursa can become infected with bacteria. This condition
is called septic bursitis.
What is knee bursitis?
The knee joint is surrounded by three
major bursae. At the tip of the knee, over the kneecap bone, is
the prepatellar bursa. This bursa can become inflamed (prepatellar
bursitis) from direct trauma to the front of the knee. This commonly
occurs when maintaining a prolonged kneeling position. It has been referred
to as "housemaid's knee," "roofer's knee," and "carpet
layer's knee," based on the patient's
associated occupational histories. It can lead to varying degrees of swelling,
warmth, tenderness, and redness in the overlying area of the knee. As compared
with knee joint inflammation (arthritis), it
is usually only mildly painful. It is usually associated with significant pain
when kneeling and can cause stiffness and pain with walking. Also, in contrast
to problems within the knee joint, the range
of motion of the knee is frequently preserved.
Prepatellar bursitis can occur when the bursa fills with blood
from injury. It can also be seen in rheumatoid arthritis and
can occur from
deposits of crystals, as seen in patients with gouty arthritis
and pseudogout. The prepatellar bursa can
also become infected with bacteria (septic bursitis). When this happens, fever
may be present. This type of infection usually occurs from breaks in the
overlying skin or puncture wounds. The bacteria involved in septic bursitis of
the knee are usually those that normally
cover the skin, called staphylococcus. Rarely, a chronically inflamed
bursa can become infected by bacteria traveling through the blood.
Gout is a condition that results from crystals of uric acid depositing in tissues of the body. Gout is a condition that can lead to abnormally elevated levels of uric acid in the
blood, recurring attacks of joint inflammation (arthritis), deposits of
hard lumps of uric acid in and around the joints, and decreased kidney
function and kidney stones.
The knee joint is composed of three compartments and ligaments which stabilize the joint. Causes of knee pain may include injury, degeneration, infrequently infection and rarely bone tumors. Although routine x-rays do not revel meniscus tears, they can be used to exclude other problems of the bones and tissues. The knee joint is the most commonly involved joint in rheumatic disease, as well as immune diseases that affect various tissues of the body.
Bursitis is inflammation of a bursa. A bursa is a tiny fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body. There are 160 bursae in the body. The major bursae are located adjacent to the tendons near the large joints, such as the shoulders, elbows, hips, and knees.
Chronic pain is pain (an unpleasant sense of discomfort) that persists or progresses over a long period of time. In contrast to acute pain that arises suddenly in response to a specific injury and is usually treatable, chronic pain persists over time and is often resistant to medical treatments.
Nonsteroidal antiinflammatory drugs (NSAIDs) are prescribed medications for the treatment of inflammatory conditions. Examples of NSAIDs include aspirin, ibuprofen, naproxen, and more. One common side effect of NSAIDs is peptic ulcer (ulcers of the esophagus, stomach, or duodenum). Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking NSAIDs.
Osgood-Schlatter disease, a painful inflammation just below the knee but above the shin, typically affects adolescent boys. Symptoms include localized pain, inflammation, swelling, and calcification. Osgood-Schlatter disease typically goes away over time, however, symptoms can be helped with antiinflammatory and pain-relieving medications, ice, and rest.
Gout is a disease that results from an overload of uric acid in the body. This overload of uric acid leads to the formation of tiny crystals of urate that
deposit in tissues of the body, especially the joints. When crystals form in the joints, it causes recurring attacks of joint
inflammation (arthritis). Gout is considered a chronic and progressive disease. Chronic gout can also lead to deposits of hard lumps of uric acid in the tissues, particularly in and around the joints and may cause joint destruction, decreased kidney function, and kidney stones (nephrolithiasis).
Gout has the unique distinction of being
one of the most frequently recorded medical illnesses throughout history. It is
often related to an inherited abnormality in the body's ability to process uric
acid. Uric acid is a breakdown product of purines that are part of many foods we
eat. An abnormality in handling uric acid can cause attacks of p...
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