Dr. Ai-Hsi Liu, MD

Both injection and aspiration are techniques that involve inserting a needle connected to a syringe directly into the joint. Aspiration involves the removal of excess fluid, and injection is the placement of medication directly into the joint space via the needle. Both procedures may be performed at the same time. In both cases a local anesthetic may be used, the skin will be cleaned and disinfected, and then the needle will be inserted. In some cases, especially if the injection or aspiration is in a large and deep joint such as the hip or spine, ultrasound may be used to guide the needle to the exact location desired.

In some cases, irritation to the joint can cause fluid to build up so significantly that the joint hurts and can no longer move well. Aspiration removes some of the excess fluid and relieves the pressure. In addition, aspiration can be used to provide a sample of joint fluid if it needs to be examined microscopically for the presence of white blood cells, bacteria, or crystal formations.

Certain injuries and diseases that affect joints are inflammatory in nature, such as rheumatoid arthritis, tendonitis or gout. These diseases may be helped by the local injection of anti-inflammatory medications directly into the affected joint. In this case, corticosteroids such as methylprednisone are usually used. Relief from the pain may be felt right away and may last for weeks or even months.

In some cases, such as with osteoarthritis, the cartilage buffer between the two bones wears down and pain comes from bones rubbing against each other. In this case, injection of a lubricating agent such as hyaluronic acid may be beneficial. It provides a slippery cushion between the bones to relieve pain that can last for months.

Kidney stones can be smooth or jagged and are yellow to brown in color. They are mostly comprised of the minerals calcium, oxalate, and phosphorus. Examining the stones to see what they are made of can show what caused the stone to be formed in the first place. For example, a stone made of mostly calcium, which is the most common type, can happen any time the urine becomes too concentrated due to dehydration or a blockage in the kidney. A uric acid stone forms when acid levels in the urine get too high, usually due to excessive consumption of animal protein such as meat and fish. A struvite stone is a sign of certain infections, and a cystine stone can be due to a genetic disorder that raises the risk of kidney stones.

The most common symptom of kidney stones is pain, either in the back or lower abdomen, or severe pain when urinating. There may also be blood in the urine. Treatment for kidney stones depends on how large the stone is. Very small stones can pass out of the body on their own, and they do not require treatment other than drinking adequate water and taking pain killers. Larger stones need to be broken apart and removed. The main treatment options are:

• Shock wave lithotripsy, which uses sound wave vibrations to break apart the stone
• Percutaneous nephrolithotomy, or the use of a very tiny tool (like a wire inserted through the back) to break apart and remove the stone
• Ureteroscopy, a thin tube inserted through the urethra and bladder to the stone, where tiny tools can grasp the stone and remove

People who have had one kidney stone are at risk of developing another. To reduce this risk, patients are given instructions specific to the type of stone they developed. Generally the instructions will include drinking more water to dilute the urine, but it may also involve lowering sodium intake or eating less meat.

Asthma is a chronic disease where swollen, inflamed airways make it hard to breathe. It is often brought on by specific triggers. While asthma is a common condition, affecting millions of people, it can also be serious and even fatal in severe cases. Treatment involves avoiding triggers and using inhaled corticosteroid medications.

COPD, or Chronic Obstructive Pulmonary Disease, is the name given to two illnesses that both cause difficulty breathing: emphysema and chronic bronchitis. In emphysema, the air sacs of the lungs become damaged, while with bronchitis they become clogged with mucus. COPD is the fourth leading cause of death in the United States. It is almost always caused by breathing irritants into the lungs, such as smoking or heavy pollution.

Pneumonia is a lung infection that can be caused by bacteria, a virus, or fungi. Most healthy people recover from pneumonia in a week or two, but for some people pneumonia can be fatal. There are treatments available for pneumonia, but the best treatment is to prevent getting sick in the first place. People who are at risk should make sure they get a flu shot every year. There is also a vaccine available for the type of bacteria that causes pneumonia.

Lung cancer occurs when abnormal cells inside the lung grow into a tumor, destroying healthy tissue. Because it is so difficult to detect lung cancer in early stages when it has few symptoms, it is the deadliest form of cancer, responsible for the most cancer deaths both in the U.S. and worldwide. Most lung cancer is caused by exposure to tobacco smoke, but between 10-15% of cases are not linked to smoking.

Some problems with the lungs are minor and are not cause for concern. However if symptoms have lasted for a month or more, even if they are minor, it is worth checking with a healthcare professional. A cough, shortness of breath, or excess mucus production that lingers for weeks are all worth getting looked at.