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Rachel Yep, DNP, FNP is a nurse in McLean, VA specializing in family medicine. Rachel Yep, DNP, FNP is affiliated with MedStar Georgetown University Hospital and MedStar Health.
1420 Beverly Road Suite 210
McLean, VA 22101
3800 Reservoir Road Northwest 1 Gorman
Washington, DC 20007
5454 Wisconsin Avenue Suite 1100
Chevy Chase, MD 20815
Joint Injections
A joint is any area of the body where two bones connect. Due to injury or disease, the space between the two bones can sometimes become swollen and inflamed, which leads to pain and a loss of mobility. Injection and aspiration are two tools that physicians use to treat joint pain locally without needing to perform surgery.
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.
Replacement Arthroplasty (Joint Replacement)
Joint replacement, sometimes also called arthroplasty, is an option when a joint becomes severely damaged by disease or injury. The damaged cartilage of the joint is surgically removed, the ends of the bones in the joint are resurfaced, and a prosthetic is installed. Most prosthetic joints are made of a metal piece that fits into a plastic sleeve so that they glide smoothly. A joint replacement increases stability in the damaged area and decreases pain. The hip and knee are the two joints most commonly replaced, but joint replacement can also be performed on the ankle, shoulder, elbow and even fingers.
Although joint replacement is one of the safest and most reliable medical procedures available, it is still a major surgical procedure. All surgical procedures carry risks, such as infection or blood clots. For this reason, doctors try to help their patients avoid surgery for as long as they can. Taking arthritis medications, losing weight, avoiding high impact sports such as running, taking supplements such as glucosamine or chondroitin, or having joint injections may allow a patient to enjoy life without the need for surgery.
After having joint replacement surgery, patients can expect some pain the first few days as they recover. Physical therapy is an important part of recovery, and it can decrease complications and increase future mobility. As soon as possible, returning to low impact sports such as swimming, walking or biking can stretch and heal the new joint. A prosthetic joint can last 15 - 20 years and cannot be further damaged by degenerative diseases such as arthritis, so once it is done patients should be pain-free for many years.
Shoulder Arthritis
Shoulder arthritis is a very common condition that causes pain, stiffness, or a grinding sensation in the shoulder. Some patients may hear a clicking or popping noise, and all symptoms are more noticeable when moving. Arthritis occurs when the cartilage that cushions joints becomes damaged.
Normally, when two bones come together inside a joint, they are separated by a layer of tough, smooth cartilage. The cartilage allows the bones to glide across each other, which makes movement easier. Cartilage can be damaged by an injury, by an illness such as rheumatoid arthritis, or by simple wear and tear (osteoarthritis). In the shoulder, the two joints most commonly affected are the AC joint (where the shoulder blade and collarbone connect at the outside edge of the shoulder), and the glenohumeral joint (where the arm bone meets the shoulder blade).
Treatment for shoulder arthritis may include:
Surgical treatments include the removal of inflamed tissue and joint reconstruction. The type of arthritis and severity of the damage will determine which treatment is most appropriate.
She has a state license in District of Columbia.
Licensed In: District of Columbia
Rachel Yep, DNP, FNP is associated with these hospitals and organizations:
Rachel Yep, DNP, FNP appears to accept the following insurance providers: Aetna Medicare PPO, CIGNA EPO, CIGNA Indemnity, Private Healthcare Systems (PHCS), Medicare Advantage, MAMSI, AARP, Coventry National Network PPO, Aetna, United Healthcare Choice Plus, Blue Choice, United Healthcare Choice, First Health PPO, TRICARE Prime, United Healthcare, Great-West Healthcare, Medicaid, Cigna, TRICARE, Coventry, Aetna Managed Choice POS, First Health, Aetna HMO, Kaiser Permanente, Optimum Choice Preferred (POS) & OCI Direct (HMO), MedStar Family Choice - Maryland Health Choice, Medicare Fee for Service, Choice Fund PPO, CFBSBC Blue Preferred PPO, CFBCBS (NCA) Indemnity, M.D. IPA (HMO), Open HMO, M.D. IPA Preferred (POS), POS OA & OA Plus, MedStar Select (MedStar Associates' Plan), Network OA, Innovation Health: PPO, Opoen HMO Option, CFBCBS Maryland Indemnity or PPO, CFBCBS EPO, Innovation Health: Indemnity, Innovation Health: POS, CFBCBS Maryland Point of Service Plan (MPOS), Innovation Health: Open POS Plus, Choice POS & Choice POS II, United Student Resources, Select HMO/HealthFund/Health Network, HealthyBlue PPO, CFBCBS Federal Employee Program (Std/Basic PPO/Blue Focus), Open EPO Plus, Innovation Health: Open Network Only Plus, Open POS II, Innovation Health: POS Plus and PPO and PPO Plus.
According to our sources, Rachel Yep, DNP, FNP accepts the following insurance providers:
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Ms. Rachel Yep is a specialist in family medicine. Clinical interests for Ms. Yep include meniscus surgery, frozen shoulder, and forearm fracture. She is affiliated with MedStar Georgetown University Hospital. Ms. Yep accepts Blue California, Coventry, and Coventry Health Care Plans, in addition to other insurance carriers.