.JPG&w=300) In this glossary you will find an illustrative explanation of some keywords which are frequently used in research papers and, more general, in updated Orthopaedic Medicine Cyriax, as well as some summarized descriptions of certain clinical images and diagnostic procedures
General remark : sometimes I refer the reader to "Part I" and "Part II" for further information on that specific subject i.e. the two books "Orthopaedic Medicine Cyriax : updated value in daily practice, Part I and Part II "
I also refer to the interesting glossary of some other publications such as :
"Orthopaedic Medicine, a practical approach ; Kesson-Atkins, 2nd edition, Elsevier BH 2005" and
"The lumbar spine, mechanical diagnosis and therapy, volume one, McKenzie-May, Spinal publications New Zealand 2003"
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Achilles tendinosis
A tendinitis / tendonitis lesion of the achilles tendon is very common : mostly the lesion lies at the medial/lateral aspect of the achilels tendon in combination with the anteromedial or anterolateral part.
A lesion at the insertion is possible too, but is rather rare. Palpation will be conclusive. Deep transverse friction massage in combination with eccentric exercise therapy is a good treatment strategy. In exceptional cases an infiltration could be useful.
Mostly twee different friction massage techniques need to be combined.
(Part I, p154-155 ; Part II, p35-36)
Read on...
Acromioclavicular lesion
Most acromioclavicular -joints have an C4-origin and thus refer pain in the C4-dermatome.
There can be a lesion of the superficial and/or deeper part and this reflects in the clinical image.
The superficial lesion reacts well on deep friction massage ; the deeper lesion reacts better on infiltration.
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Adductor lesion
A lesion of the adductor muscles in the groin is very frequent, especially among football payers : we distinguish between a tenoperiostal lesion and a lesion at the musculotendinous junction. Resited adduction of the hip will be painful, passive abduction can be painful, tenderness on palpation should be positive too, if not, a pubis fracture could be a differential diagnostic option.
The tenoperiosteal part can be infiltrated or friction massage can be given.
If the lesion lies at the musculotendinous junction deep transverse friction massage is the better option.
(Part I, p108 ; Part II, p24)
Read on...
Adherent nerve root
A past lumbar internal derangement causing an episode of sciatica has resolved but the repair process has left some tethering or adherence that now inhibits full movement of the nerve root/dural complex
Flexion in standing is limited and the patients feels end-range pain in the back or the leg (this is the only dysfunction that can cause peripheral pain ; all others cause spinal pain only).
The treatment of an adherent nerve root will consist of
an intense stretching program.
Read on...
Allodynia
Pain produced by a stimulus which is not normally painful.
Read on...
Ankle sprain
An ankle sprain mostly is a complex mutlifactorial lesion. We distinguish between a varus and a valgus trauma. The varus trauma occurs much more frequent : mostly we think of a separate or combined lesion of the talofibular ligament, the calcaneofibular ligament, the calcaneocuboid ligament and the peroneal tendons.
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Anterior periostitis
Anterior periostitis (contact between the anterior tibia and collum tali) : gymnasts experience a sudden anterior pain on landing on flat feet with the knees flexed after a jump. A raised heel could be helpful symptomatically.
In the functional examination there is end range pain on passive dorsiflexion.
This lesion reacts well on infiltration.
Read on...
Arthritis - arthrosis
A patient suffering from a symptomatic arthrosis or arthritis clinically shows a capsular pattern.
There are many kinds of arthritis that can be distuinguished on data obtained from the history and clinical examination.
Mobilization, stretching or injection can be treatment options.
If there is no capsular pattern in the functional examination, most likely the alledged arthrosis or arthritis is not responsible for the actual complaints and the lesion should be looked for elsewhere.
(Part I, p10-11)
Read on...
Associated tenderness
Associated tenderness
A nearby structure can be more tender than the lesion itself. This occurs at :
* type 2 tennis elbow (origin of extensor carpi radialis brevis muscle) : posterior aspect of the epicondyle is more tender than the contractile structure itself. It may be tempting to focus the treatment towards that tender spot, but it is merely misleading.
* de Quervain's disease : the radial styloid process can also be more tender than the tendons in the first dorsal tunnel.
Read on... |
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