.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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Radial nerve pressure
Pressure on the radial nerve (rare)
* A minor subluxation of the scaphoid bone can cause pressure on the radial nerve in the anatomical snuff-box, resulting in limited wrist extension with paraesthesia at the dorsum of the 3 ½ radial fingers. The treatment is manipulation.
* An osteoma at the dorsum of the base of the third metacarpal bone can cause pressure on the branch of the radial nerve to the index and middle fingers. Moving the hand from side to side with the wrist flexed causes a sharp twinge and a few minutes paraesthesia at the dorsum of index and middle fingers. Surgery might be needed.
* Friction of the sensory branch of the radial nerve against the lower edge of the radius can cause paraesthesia. Paraesthesia is provoked by maximal stretching of the nerve : bringing the dependant straight arm backwards, twisting it into full medial rotation, then pronating the forearm with bent wrist and fingers. Triamcinolone is used.
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Referred pain
Soft tissue lesions mostly refer pain in a distal direction ; the real cause of the referred pain can lie outside the painful region. Different factors affect the intensity and localisation of the referred pain. Referred pain can be segmental or extrasegmental (= typical for dura mater).
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Release phenomenon thoracic outlet
The sensation of deep (painful) paraesthesia occuring as pressure is released from a nerve trunk.
Release phenomenon : the paraesthesia only appears after the compression has ceased.
There is a clear relationship between the duration of the compression and the length of the interval between cessation of compression and appearance of paraesthesia.
Example : standing up after sitting with the knees crossed for some time, immediately followed by paraesthesia. During compression there are no paraesthesia, they only appear when the compression is released. A similar mechanism is described in the thoracic outlet phenomenon.
The nervous structures in the distal half of the upper limb constitute an exception to the
release phenomenon : pressure on the median, ulnar and radial nerve immediately cause symptoms.
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Reliability
This is the characteristic of a test or a measuring tool to give the same answer in different situations. Inter-tester reliability examines the degree of agreement between different clinicians on the same occasion. Intra-tester reliability examines the degree of reliability of a single tester on different occasions. Results are presented in several ways : as a percentage agreement, correlation coefficients, or Kappa values.
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Retrocalcanear bursitis
Palpation behind the achilles tendon is much more tender than the achilles tendon itself. Very localized pain.
In the functional examination there is posterior pain on passive plantarflexion, end range.
A retrocalcanear bursitis reacts well on infiltration.
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Rotator cuff
Rotator cuff lesions in the shoulder need to be diagnosed more specifically if possible. Mostly a distinction between supraspinatus, infraspinatus, biceps, and subscapularis is possible on clinical grounds. Sometimes a combined lesion is seen.
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