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Dysfunction syndrome Sometimes patients patients present with double clinical images : an internal derangement (disc) can be combined with an underlying dysfunction syndrome. Mostly the image of the internal derangement is prominent ; once this derangement is reduced, then the image of the dysfunction becomes more obvious. Typical for a dysfunction syndrome is the fact that normal loading or tension on abnormal tissue (inflamed, shortened,..) will cause symptoms. Patients will describe end range pain on certain movements. The patient's reaction on repeated movements will be diagnostically helpful : repeated movements will produce the same end range pain all over again, but after some repetitions the patient is not better, nor worse. Patients with a dysfunction syndrome react well on a stretching program.
(Part I, p182)
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