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Glossary

Below is a glossary of common 'medical terms' used in orthopaedics.

Abduction

 Movement away from the midline of the body

Abscess

 A mass containing pus.

Acetabulum

 The socket of the hip joint

Achilles tendinitis

 Inflammation around the Achilles tendon

Acromion

 The shelf of bone just above the shoulder joint

Adduction

 Movement towards the midline of the body

Adhesive capsulitis

 an acutely stiff shoulder joint due to tightening of the capsule AKA 'frozen shoulder'

Allograft

transpanted human bone

Ambulating

walking

Amenorrhea

 cessation of periods (common in overtraining sportswomen)

Analgesic

 any painkiller

Anaphylaxis

a severe allergic reaction causing a drop in blood pressure and difficulty in breathing

Ankylosing spondylitis

 an inflammatory disorder that affects the back, pelvis and major joints characterized by pain and severe stiffness

Ankylosis

 a severe loss of joint movement often due to spontaneous fusion of the joint

Annulus fibrosus

 the edge of the intervertebral disc between the spinal vertebrae

Anterior

 towards the front of the body

Anterior cruciate ligament

 one of the main stabilizing ligaments in the knee

Arthrodesis

 the surgical fusion of a joint.

Arthrography

 a special radiographic technique where a contrast medium is injected into a joint to outline the joint surface more clearly. It may refer to x-ray, CT or MRI

Arthroplasty

replacement of a joint. Excision arthroplasty implies the joint has been removed to allow a scar tissue joint to form. Hemiarthroplastly means only one half of the joint has been replaced

Arthroscopy

 an operation to view the inner surface of a joint via a small fibreoptic tube and miniature video camera

Articular cartilage

 the smooth, firm surface that covers the ends of bones at a joint

Aspiration

 removing fluid from a joint with a needle (also known as athrocentesis)

Athlete's foot

 a fungal infection of the toe web spaces.

Atrophic nonunion

 Where the bone is not uniting together, and there is no evidence of healing bone.

Autograft

 tissue from the patient's own body (eg bone graft from one part of the body such as the hip to another area)

Autonomic dysfunction

 a form of complex regional pain syndrome where changes in colour and temperature of the skin pain may be the most significant feature rather than pain.

Autonomic nervous system

 The system of nerves that controls things that happen unconsciously in the body such as blood flow, heart rate etc. Also can control the level at which the triggering of nerves is perceived as pain. 

Avascular necrosis

 a condition in which cells die as a result of inadequate blood supply, (also known as  osteonecrosis)

Axial plane

 One of the three planes through the body akin to a cross section

Axonotmesis

 a nerve injury where the nerve is damaged, but not severed

Bankart lesion

 a shoulder injury where the tough firous tissue at the front of the shoulder joint gets torn off in dislocation.

Biceps tendinitis

 inflammation of the biceps tendon at the top of the shoulder

Biomechanics

 an assessment of physical forces and how they are transmitted in the body

Bipartite patella

 A normal condition where part of the patella may be separated and appear as a fracture

Bisphosphonates

 Drugs that affect bone metabolism used in the treatment of a variety of bone diseases and to treat some forms of osteoporosis.

Bone densitometry

 A scan to assess to assess for osteoporosis using xrays (also known as a DEXA scan)

Bone remodeling

 The maturing and change of shape of a bone, usually after a fracture

Bone scan

 A scan that involves injection of a weakly radioactive marker to show areas of high metabolic activity in bone. Also known as  bone scintigraphy

Boutonniere deformity

 A finger deformity due to rupture of one of the tendons

Bucket-handle tear

 A tear along the meniscal cartilage whereby the torn fragment flips into the joint like the handle of a bucket

Bunion

A painful soft tissue lump over the big toe joint, usually over a bony deformity (hallux valgus)

Bursa

 A sac containing a thin film of fluid that allows tissues to glide across each other. Can get inflamed and swollen (bursitis)

Bursitis

 Inflammation of a bursa

Burst fracture

 A compression fracture of a vertebra causing posterior displacement of the fragments into the spinal canal

Butterfly fragment

 a wedge shaped piece of bone separated at a fracture site

Cafe au lait spots

 Pale brown pigmented skin marks

Calcaneus

 Heel bone. Also known as the os calcis.

Callus

 Healing bone which is incompletely calcified

Capillaries

 Small, thin-walled blood vessels that provide the nutrition to cells

Capsule

 The tough fibrous surrounding of a joint

Carpal tunnel syndrome

 Compression of the Median nerve at the wrist that is characterized by pain, numbness, and weakness in the hand.

Carrying angle of the elbow

 The angle formed by the long axis of the humerus and the ulna bone in the forearm

Cartilage

A type of body tissue characterized by collagen of various types. Articular cartilage forms the smooth lining of joints, Fibrocartilage is similar to scar tissue. The 'knee cartilage' is a lay term for the medial or lateral meniscus.

Cavus

 Excessive height of the arch of the foot

Cellulitis

 Inflammation of soft tissues or skin tissue, due to infection

Chondral injury

 an injury involving the articular cartilage that lines a joint

Chondroblasts

 The cells that form cartilage

Chondrocytes

 The biologically active cells in cartilage.

Chondromalacia

 Softening of the articular surface that can result in pain.

Chondrosarcoma

A cancer of cartilage cells

Claudication

A pain in the calf that gets worse with activity, usually either due to poor circulation (vascular claudication) or pinching of the nerves from spinal stenosis (spinal claudication)

Clavicle

 The collarbone

Claw toe

 Deformity of the toe where the tip comes off the ground

Closed fracture

 A fracture that has not penetrated the skin

Closed reduction

 Straightening a bone without opening the skin

Collagen

 A strong structural protein found in hyaline cartilage, bone, tendon and ligaments

Colles fracture

 A fracture of the distal end of the radius (wrist) where the bone is crushed into itself, causing the distal part to tilt dorsally and rotate to the radial side

Comminuted

 broken into more than one piece (also multi-fragmentary)

Common peroneal nerve

 One of the nerves in the lower leg that supplies the lateral (peroneal) muscles

Compartment syndrome

 increased pressure in the muscular compartments (usually of the lower leg) resulting in severe pain. It can either be acute after injury or chronic in athletes

Compound fracture

 the historic term for an open fracture (qv)

Condyle

 The expanded end of a bone at the joint

Contracture

 A restriction of movement of a joint due to shortening of the muscles around it

Contusion

 An injury to soft tissue without a break in the skin such as a bruise

Coronal plane

 One of the three planes through the body akin to a frontal view

Cortical bone

 Dense bone that forms the tubular surface of the long bones

Corticotomy

 Similar to an osteotomy, but with an attempt to keep the central part of the bone intact. Usually performed for the Ilizarov technique of bone lengthening

Coxa magna

 A deformity of the hip in which the ball of the hip joint is enlarged.

Crepitus

 crunching feeling from roughened surfaces of a joint, or bones moving relative to one another

Curettage

 Scraping the inner surface of a cavity with a surgical instrument called a curette

Deep venous thrombosis (DVT)

A blood clot in the veins (usually of the calf). It is commonly caused by immobility and surgery

Degloving

 Stripping of a layer of skin and its subcutaneous fat from the underlying fascia resulting in the severence of its blood supply

Delayed union

 A delay in fracture healing beyond what is normally expected

Delayed-onset muscle soreness (DOMS)

 Muscle pain that follows unaccustomed vigorous exercise and that can last several days despite rest.

DEXA scan

 Dual-energy x-ray absorptiometry A diagnostic imaging technology that uses two different energies of x-rays to detect osteoporosis

Diaphyseal

 Relating to the shaft of a long bone.

Diaphysis

 The shaft of a long bone.

Diastasis

 Separation of the tibia and fibula at the ankle

Discoid meniscus

 A congenital deformity in which the lateral meniscus is not the normal crescent shape but instead is a circular disc

Dislocation

 Complete separation of the articular surfaces of a joint

Distal

 Further away from the centre of the body

Distraction

 The action of stretching a bone at a corticotomy to lengthen it

Dorsal

 Relating to the back of the body and hand or top of the foot

Dysplasia

Not formed properly during growth (notably the hip joint in developmental dysplasia, DDH)

Eccentric

 Specific exercises in which the muscle lengthens despite resisting a force, such as lowering a weight in a controlled manner

Ecchymosis

 Localized bruising in the skin

Effusion

 swelling of a joint with fluid

Effusion

 A swelling due to fluid within a joint

Epiphysis

The end of a growing bone that is on the side of the joint compared to the growth plate.

Equinus

 Plantar flexed position of the foot at the ankle joint

Erythema

 Redness of the skin

Ewing sarcoma

 A specific type of bone cancer

Exostosis

 Bony spur or projecting growth

Extension

 Movement of a joint towards the dorsum (as opposed to flexion)

Extensor

 A muscle that causes extension of a joint

External fixation

 The use of an external frame scaffold to support bone and joints, attached by means of pins and wires into or through the bones. May be completely around a limb (circular frame) on one side (unilateral frame) or mixtures.

External rotation:

outward rotation of a limb

Fascia

 Sheets of tough fibrous connective tissue that divide the limbs into layers and compartments

Fasciotomy

Surgical incision of the fascia, usually to relieve the pressure of compartment syndrome

Fat embolism syndrome

 When fat globules get into the lungs and cause a pulmonary embolism as well as passing through the lungs to cause micro-emboli in the brain and other organs.

Fatigue fracture

 A fracture that occurs when the bone is subjected to frequent, repeated stresses. Common in marathon runners and army recruits.

Femoral head

 Proximal end of the femur that forms the ball of the hip joint

Femoral neck

 The bone connecting the head to the shaft of the femur

Femoral nerve

 The nerve that supplies power to the quadriceps muscles and feeling to the overlying skin

Fibrocartilage

 Tough scar tissue. Can be used as a substitute joint lining if the hyaline (articular) cartilage is lost, but is not of the same quality.

Fibula

  the smaller of the two bones in the lower leg. It lies to the outer side and slightly behind the tibia and forms the outer part of the ankle joint by an expansion at the lower end called the lateral malleolus.

Fibular

on the outer side of the calf

Flexion

 Movement of a limb towards the front

Flexor

 A muscle that flexes a joint

Fluoroscopy

 The use of an image intensifier x-ray machine to take continual images

Foramen

 A gap or hole either through or between bones

Fracture

 any broken bone from a hairline crack to something totally shattered

Freiberg's disease

 A condition that causes avascular necrosis of the second metatarsal head

Frozen shoulder

 A condition causing severe stiffness of the shoulder (adhesive capsulitis)

Functional pain

 Pain that is felt by the patient when there is no anatomical cause

Fusion

 The healing together of two bones at a joint either intentionally (arthrodesis) or as a result of arthritis(ankylosis)

Galeazzi fracture

 A fracture of the radius with dislocation of the ulna at the wrist

Gamekeeper's thumb

 Rupture of the ulnar collateral ligament of the thumb

Ganglion

 A soft tissue lump caused by a herniation of the synovial lining of a joint, and as such filled with joint fluid that becomes thick and viscous.

Gastrocnemius

 The major muscle of the calf that inserts into the heel via the Achilles tendon

Genu valgum

 A knock knee type deformity

Genu varum

 A bow leg type deformity

Gerdy's tubercle

 The attachment site of the ITB (ileotibial band) on the outer tibia

Glenohumeral joint

 The shoulder joint between the ball at the head of the humerus and the shallow glenoid part of the scapula

Gout

 An inflammatory arthritis caused by deposition of urate crystals in a joint

Gracilis

 One of the three hamstring muscles to the medial side of the knee

Greater trochanter

 The widened part of the upper end of the femur to which muscles attach. It has an overlying bursa beneath the fascia which may get inflamed (trochanteric bursistis)

Greenstick fracture

 A childhood fracture that disrupts only one side of the bone.

Haemarthrosis

 swelling of a joint due to bleeding into the joint

Haematoma

 bleeding into soft tissues akin to bruising

Hallux

 The big toe

Hallux rigidus

 Arthritis of the major joint of the big toe (the metatarsophalangeal joint) causing stiffness and pain

Hallux valgus

 Deformity at the first metatarsophalangeal joint where the toe deviates laterally causing pain and an overlying soft tissue swelling (bunion.)

Hammer toe

 Deformity of the farthest toe joint (distal interphalangeal joint, DIPJ) that causes the tip of the toe to dig into the ground painfully

Hamstrings

The muscles at the back of the thigh that flex the knee. On the medial (inner) side are the gracilis, semimembranosis and semitendonosis. On the outer side are the biceps femoris muscles

Hemarthrosis

 Swelling due to  blood within a joint.

Hematoma

 A soft tissue swelling due to bleeding, a bruise.

Hemiplegia

 Paralysis of one side of the body.

Heterotopic ossification

 The formation of bone in the soft tissues.

Hill-Sachs lesion

 An indentation of the bone of the head of the humerus against the glenoid rim in shoulder dislocation.

Hydroxyapatite

A ceramic mineral that is present in bone and can stimulate bone to heal to a surface.

Hypermobility syndrome

 Abnormal flexibility of joints, usually graded by hyperextension of knees and elbows, the ability to touch the forearm with the thumb, bend the little finger back by 90 degrees and touch the floor with the palms.

Hypertrophic nonunion

 Where the bones are trying to unite by producing extra bone, but it is not bridging the fracture together

Iliotibial band (ITB)

 The sheet of tissue along the side of the thigh to below the knee.

Impacted fracture

 A fracture pattern in which the fragments are squashed into each other.

Insertion

 The attachment of the tendon of a muscle

Instability

 A symptom where a joint is unstable and will collapse under load

Internal fixation

 The use of metal screws, plates,  nails etc to hold the parts of a fracture together. Often combined as open reduction and internal fixation or ORIF

Internal rotation

 Inwards  rotation of an limb

Intervertebral disc

 A soft disc between the vertebral bodies comprising a tough outer skin (annulus fibrosus) with a soft inner part (nucleus pulposus)

Intracapsular fracture

 Fracture within the capsule of a joint.

Intramedullary nailing

A method of internal fixation of the long bones using a metal rod within the hollow centre of the bone. Often additional screws lock through the nail (interlocking intramedullary nail)

Inversion injury

 A twisting injury to the ankle characterized by the sole of the foot turning inwards, stressing the ligaments on the outer side of the ankle

Ischemia

 Inadequate blood supply to an area of the body

Isokinetic

 Use of a muscle so the speed of contraction is constant

Isometric

 Use of a muscle without it changing length

Isotonic

 Use of a muscle such that it contracts and shortens with constant tension

Jones fracture

 A fracture at the bse of the 5th metatarsal on the outer side of the midfoot involving the joint with the cuboid bone

Jumper's knee

 Pain at the upper end of the patellar tendon where it attaches to the patella, also known as patellar tendonosis

Kyphosis

 Curvature of the spine such that that is convex posteriorly ie hunched forwards

Lachman test

A test of anterior to posterior laxity of the knee which assesses the cruciate ligaments

Lateral

 Further away from the midline

Lateral epicondylitis

Inflammation of the lateral epicondyle of the humerus, also known as tennis elbow.

Lateral malleolus

Bony prominence at the end of the fibula that forms the outer aspect of the ankle joint

Lateral meniscus

The outer of the two crescent-shaped fibrocartilages is the knee joint that lie between the femur and the tibia

Lavage

 Washing out of a joint or body cavity

Laxity

 Abnormal slackness in a joint allowing movement in an abnormal direction

Ligament

 A structure running from one bone to another bone to stabilize a joint

Limb salvage

 The use of complex orthopaedic techniques to try to save a limb that would otherwise be at risk of amputation from the complications of trauma or infection

Lisfranc fracture

 A fracture-dislocation of the tarsometatarsal joints between the tarsal bones in the midfoot and the metatarsals in the forefoot

Lordosis

 Curvature of the spine that is convex anteriorly

Low-molecular-weight heparin (LMWH)

 Injectable anticoagulants to try to prevent, and in some cases treatdeep venous thrombosis (DVT)

Magnetic resonance imaging (MRI)

An imaging technique that uses the tiny radiofrequency echoes given off by protons in water when subjected to a moving magnetic field within a stronger field. It gives very good views of soft tissues that otherwise do not show up on xray. The image can be adjusted to show up high water content for example in inflammation and acute soft tissue injuries.

Mallet finger

A rupture of the extensor tendon to the tip of the finger such that it cannot be properly straightened. Sometimes a small piece of bone is pulled off with the tendon.

Malunion

 Healing of a fracture in a deformed position

Medial

 towards the midline of the body

Medial collateral ligament

 A ligament that stabilizes the inner (medial) aspect of a joint

Metacarpals

 Bones in the hand between the wrist and fingers

Metaphysis

 The widened part of a bone towards the joint

Metastasis

 The spread of disease such as cancer from one part of the body to another, usually via the bloodstream

Metatarsalgia

 Pain in the forefoot beneath the metatarsal heads

Metatarsals

 The bones in the front part of the foot between the midfoot and the toes

Monteggia fracture

 A fracture of the ulna bone of the forearm with dislocation of the head of the radius at the elbow

Morton's neuroma

 A painful swelling of the nerve between the metatarsal heads of the forefoot.

Multi-fragmentary

 broken into more than one piece (also comminuted)

Myositis ossificans

 The formation of bone within muscle, often as a result of trauma.

Navicular

 One of the bones in the top of the foot between the talus and the cuneiform bones

Neurapraxia

 A temporary loss of function of a nerve, usually from pressure

Neuritis

 Inflammation or irritation of a nerve

Neuroma

 A swelling of a nerve or its surrounding sheath

Nonsteroidal anti-inflammatory drugs (NSAIDs)

 A broad group of painkillers that includes aspirin,  ibuprofen, diclofenac, naproxen and others. Implicated in slow bone healing and possible non-union.

Nonunion

 Failure of healing of a fracture or an osteotomy.

Nucleus pulposus

 The shock absorbing central part of the intervertebral disc

Oedema

 Swelling due to retained tissue fluid

Olecranon

 The projection at the back of the elbow from the proximal end of the ulna.

Open fracture

 a fracture where the bone has come through the skin. Notably serious since germs can get in to the fracture site and cause osteomyelitis

Open reduction and internal fixation (ORIF)

 An operation that involves opening the skin and soft tissue to fix  a fracture under direct vision with metalwork such as plates and screws etc.

Origin

 The attachment of the more major end of a muscle

Os calcis

 Latin name for the heel bone (calcaneus)

Osgood-Schlatter disease

 Pain at the front of the knee from the tibial tubercle classically in adolescent sportsmen that is usually associated with a local swelling

Osteitis pubis

 Inflammation of the pubis symphysis (the junction between the two pelvic bones at the front of the body)

Osteoarthritis (OA)

A form of arthritis due to wearing out of the articular surface from repeated trauma

Osteoblasts

 Cells that are responsible for the formation of bone.

Osteochondral injury

 similar to the chondral injury (involving the articular cartilage that lines a joint) but that involves a piece of bone beneath it too

Osteochondritis dissecans (OCD)

 A condition where a localized are of bone beneath the joint surface dies leading to softening and possible separation of the overlying articular cartilage

Osteoclasts

 Cells that are responsible for breaking down bone.

Osteocytes

 The cells of living bone

Osteoid osteoma

 A small, benign, but usually painful bone  tumor

Osteolysis

 Reabsorption of bone

Osteomyelitis

 Infection of bone

Osteonecrosis

 a condition in which cells die as a result of inadequate blood supply, (also known as  avascular necrosis)

Osteonecrosis

 The death of bone usually because of poor blood supply

Osteopenia

 Thinning of bone not as severe as osteoporosis

Osteophytes

 Overgrowth of  bone at the edges of the joint  in osteoarthritis

Osteoporosis

 Thinning and loss of bone structure leading to weakness of the bone

Osteosarcoma

 A rare type of bone cancer

Osteotomy

 Surgically dividing a bone

Palmar

 The anterior surface of the hand

Paratenon

 A sheath of tissue around a tendon

Paresthesia

 Abnormal sensations such as tingling or 'pins and needles'

Patella

 The kneecap

Patella alta

 An abnormally high patella.

Patella baja

 An abnormally low patella due to contracture of the patellar tendon

Patellar tendon

 The tendon between the patella and the tibial tubercle at the front of the knee

Patellectomy

 Surgical excision of the patella

Patellofemoral joint

 The joint between the patella and the condyles at the end of the femur.

Pathologic fracture

 A fracture caused by a normal load on bone that is abnormally weakened for example by osteoporosis,  tumour metastases etc

Percutaneous

 The use of wires or needles the skin with only small incisions to puncture the skin

Periosteum

 The tough sheath of tissue that forms the outer surface of bones

Peroneal tendons

The tendons of the peroneal muscles that run behind the lateal malleolus at the ankle

Pes Planus

 Flattening of the arch of the foot

Phalanges

 The small bones of the fingers and toes

Physis

The growth plate. The part of the bone that is still lengthening and has not yet formed bone

Plantar

 Relating to the sole of the foot

Plantar fasciitis

 Irritation of the fascia on the sole of the foot, classically where it joins to the calcaneus at the heel.

Posterior

 towards the back of the body

Posterolateral  corner

 A complex group of tendons and ligaments at the outer side of the knee that can cause instability when injured

Pronation

 A dynamic flattening of the foot that occurs during walking and running.

Pronation

 Rotation inwards of the forearm

Proprioception

 Position sense of a joint that feeds back information about where the limb is in space to help with balance and stability

Pseudarthrosis

 A type of nonunion characterized by the formation of a false joint

Quadriceps angle (Q angle)

An angle formed by line of the patellar tendon and the line of pull of the quadriceps muscles

Radial

 On the side of the forearm or hand on which the radius lies (On the thumb side)

Radial styloid

 Bony prominence of the distal end of the radius at the wrist

Referred pain

 Pain that radiates from a pain source into an adjacent area

Remodeling

The reshaping bone undergoes after healing

Rhabdomyolysis

Excessive muscle breakdown causing the release of muscle proteins into the circulation.

Rheumatoid arthritis

One of a group of chronic inflammatory conditions that destroy a joint leading to arthritis

RICE

A method of treatment of acute injuries. It stands for rest, ice, compression and elevation.

Rotator cuff

 A group of four tendons that spread out to surround the shoulder joint to both move it and stabilize it.

Sacroiliac joint

 The joint between the sacrum and ilium of the pelvis. It lies just beneath the dimples of the buttocks.

Sacrum

The lowest end of the spine which joins with the two innominagte bones to form the pelvis

Saggital plane

 One of the three planes through the body akin to a side view

Scaphoid

 One of the bones of the wrist at the base of the thumb

Sclerosis

Thickening of bone, often seen just underneath the articular cartilage in osteoarthritis

Scoliosis

 Lateral curvature of the spine

Septic arthritis

 Infection of a joint.

Sesamoids

The bones that lie within the flexor tendon to the big toe beneath the metatarsal head

Shin splints

 An outdated term for medial tibial stress syndrome

Slipped capital femoral epiphysis

 A hip injury in adolescents where the head of femur slips off the neck  leading to pain (that may actually be felt in the knee) and in more severe cases abnormal rotation of the hip and shortening of the leg

Sprain

 An incomplete tear of a tendon or ligament

Sternum

 The breastbone

Stress fracture

 An overuse injury akin to metal fatigue where the repeated stresses on a bone outweigh its innate capacity to heal.

Subluxation

 A partial dislocation of a joint whereby there remains some contact between the surfaces

Supination

 Rotation outwards of the forearm

Syndesmosis

 The joint between the tibia and fibula above the ankle joint.

Synovial fluid

 The fluid that lubricates and provides nutrition to a joint

Synovitis

 Inflammation of the synovial lining of a joint

Synovium

 The thin fluid producing membrane that lines a joint

Tarsal coalition

 A congenital  fusion of two of of the tarsal bones of the hindfoot

Tarsal tunnel syndrome

 A painful constriction due to pressure of the posterior tibial nerve at the ankle

Tendinitis

 Inflammation of a tendon

Tendon

 The cord of fibrous tissue that forms the connection between a muscle and the bone it acts on via its insertion

Triangular fibrocartilaginous complex (TFCC)

 A small, fibrocartilaginous structure in the wrist that lies between the distal end of the ulna and the carpal bones.

Trochlea

 A concave part of a joint, classically at the distal end of the femur and the distal end of the humerus

Tuberosity

 A prominence on a bone where tendons insert.

Ulnar

On the side of the forearm or hand on which the ulns lies (Opposite to the thumb side)

Valgus

 Angulation of a limb such that the more distal part is further away from the midline

Varus

 Angulation of a limb such that the more distal part is closer to the midline

Volar

 Toward the front of the body.

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