Glossary of Terms

Glossary of spine related terms

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Abduction — Movement of an extremity away from the body.

Abscess — A pus-filled area that affects skin or organs.

Acromegaly — Overgrowth of the bones of the hands, feet, and face.

Acromion process — A lateral condensation of bone that is the attachment site for the lateral and posterior two thirds of the deltoid muscle.

Acupuncture — The insertion of needles into precisely defined points on the body; thought to realign imbalances of yin-yang and qi and thereby bring harmony to the “climate” of an individual

Adduction — Movement of an extremity toward the body.

Adenopathy — Enlargement of the glands.

Adhesive capsulitis — Self-limiting condition resulting from any inflammatory process about the shoulder in which capsular scar tissue is produced, resulting in pain and limited range of motion; also called frozen shoulder

Allergen — A substance that produces an allergic reaction. Allograft Biologic tissue from a cadaver that is used to surgically replace damaged tissue

Ambulatory condition — Assessment of the injured athlete where the athlete is seen by the athletic trainer at some point following the injury.

Amenorrhea — Loss of the menstrual cycle. Considered part of the female athlete triad.

Anabolic steroids — Synthetic derivatives of testosterone originally developed to treat hypogonadism in men, lost muscle mass in patients debilitated by illness, and severe anemia. Sometimes used to enhance muscle-building effects in athletes.

Anaerobic exercise — Exercise of short duration, not requiring the body’s utilization of oxygen to make fuel available

Anaerobic metabolism — Oxygen debt; when the cardiovascular system is unable to meet the needs of the working muscles, the anaerobic metabolism is activated Analgesia The relief of pain

Analgesic — A pain-relieving effect with no loss of consciousness. Anaphylaxis A violent hypersensitivity reaction, resulting in shock.

Angina — Chest pain.

Ankylosing spondylitis — An inflammatory disorder that affects the low back and pelvis and produces stiffness and pain

Ankylosis — Marked stiffness of a joint typically observed with end-stage arthritis, following a complex intra-articular fracture, delayed treatment of septic arthritis, or severe rheumatoid arthritis

Annulus fibrosus — A region of the intervertebral disk that provides support for the nucleus.

Antagonists — Muscles that produce body movement in opposing directions.

Anterior compartment syndrome — Increased soft-tissue pressure in the anterior compartment of the lower leg, resulting in pain, decreased sensation, and muscle paralysis

Anterior cruciate ligament tears — An acute knee injury that occurs when the foot is planted, the knee is flexed, and a valgus force is applied to the knee with the lower leg in external rotation; commonly occurs in sports that require twisting, jumping, and pivoting.

Anterior superior iliac spine — Blunt bony projection on the anterior border of the ilium, forming the anterior end of the iliac crest. Serves as the origin of the sartorius muscle.

Anterior surface — Surface at the front of the body, facing the examiner

Anteromedial rotatory instability — When the medial plateau of the tibia rotates anteriorly and medial joint opening occurs, indicating disruption of the superficial tibia collateral ligament, medial and posteromedial capsular structures, and anterior cruciate ligament

Anteroposterior (AP) view — Anterior-posterior view in which the x-ray tube is in front and the film cassette is in back. The x-ray beam passes from front to back. Antidote A substance that can counteract a poison.

Antigens — Foreign substances that can infiltrate the body, including bacteria, fungi, parasites, toxic chemicals, and abnormal body cells, prompting the production of antibodies that attempt to destroy the substances.

Anulus fibrosus — The outer ring of fibrous material surrounding the nucleus of the intervertebral disks

Aponeurosis — A broad, fibrous sheet that attaches one muscle to another.

Apophysis — A cartilaginous structure at the insertion of major muscle groups into bone that may be susceptible to overuse syndromes and acute fractures in pediatric athletes.

Appendicitis — Inflammation of the appendix, the small intestinal pouch that extends from the cecum.

Arrythmia — Irregular heartbeat.

Arterioles — Small tubular branches of the arteries.

Arthrocentesis — Aspiration of a joint

Arthrodesis — The surgical fusion of a joint. The procedure removes any remaining articular cartilage and positions the adjacent bones to promote bone growth across a joint. A successful fusion eliminates the joint and stops motion. The usual purpose is pain relief or stabilization of an undependable joint

Arthrography — A procedure in which a contrast medium is injected into a joint to outline soft tissues such as the meniscus in the knee or a torn structure such as the rotator cuff in the shoulder. MR arthrography is a technique in which a diluted contrast medium such as gadolinium is injected into a joint to improve the delineation of soft tissues. Standard MRI is obtained following the injection.

Arthrokinematic motion — Vertebral motion that occurs within the joint capsule at the articulations.

Arthroplasty — Procedure to replace or mobilize a joint, typically performed by removing the arthritic surfaces and replacing them with an implant. Total joint arthroplasty is replacement of both sides of the joint. Hemiarthroplasty replaces only one side of a joint

Arthroscopy — A form of minimally invasive surgery in which a fiberoptic camera, the arthroscope, is introduced into an area of the body through a small incision

Articular cartilage — A smooth, glistening surface that covers the ends of bones that articulate with each other to form a joint.

Aspiration — Removal of fluids from a body cavity; often done to obtain specimens for analysis

Atlantoaxial subluxation (AAS) — An orthopaedic problem seen frequently in athletes with Down syndrome that poses a significant risk to athletes participating in sports that involve bodily contact. Joint looseness, ligamentous laxity, or malformation of the vertebrae or surrounding structures causes the C1 vertebra to slip forward and compress the spinal cord, particularly when the neck is in flexion or extension.

Atlanto-occipital fusion — A rare condition consisting of congenital fusion of the ring of the atlas to the occiput; considered an absolute contraindication for contact sports.

Atlas — The first cervical vertebra (C1).

Atrium — The upper chambers of the heart, composed of the left and right atria.

Autograft — Biologic tissue from the patient’s own body that is used to surgically replace damaged tissue

Autonomic dysreflexia — A health concern for athletes with a spinal cord injury above level T8 in which the athlete experiences dizziness, sweating, headaches, and potentially severe hypertension. A plugged urethral catheter is the most common trigger; however, fecal impaction, renal calculi or infections, and pressure sores can also cause the condition.

Avascular necrosis — A condition in which cells die as a result of inadequate blood supply; see also osteonecrosis

Avulsion fracture — A fracture that occurs when a ligament or tendon pulls off a sliver of the bone

Avulsion fractures — A fracture caused by a violent muscle contraction or sudden passive stretch. Also, pulling off of the osseous insertion or origin in a child.

Axial compression — A force directed along the vertical axis of the cervical spine that is part of almost every serious injury.

Axial loading — A load directed vertically along the axis of the cervical spine during a compression force such as spearing or a head-on collision.

Axis — The second cervical vertebra (C2).

Axonotmesis — A grade II nerve injury resulting from nerve stretching in which the endoneurium remains intact.

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Bacteria — One of five types of microorganisms that commonly causes disease, characterized by absence of a nucleus and endoplasmic reticulum. Bacteria are classified according to their shape and are designated as gram positive or gram negative.

Bacteriocidal — Classification of antibiotic in which bacteria are destroyed.

Bacteriostatic — Classification of antibiotic in which bacteria are not killed, but are prevented from reproducing.

Bankart fracture — A small chip fracture off of the anterior and inferior rims of the glenoid that is seen after an anterior dislocation of the shoulder.

Bankart lesion — An anterior capsulolabral injury associated with a tear of the anteroinferior glenoid labrum.

Barbiturates — Sedative-hypnotic drugs.

Basal ganglia — Demarcated masses of gray matter in the interior of the cerebral hemispheres.

Basal metabolic rate (BMR) — The rate at which an individual burns calories while performing an activity.

Baseball finger — Rupture of the extensor tendon at or near its insertion on the terminal phalanx caused by a sudden flexion force on the distal interphalangeal joint while the finger is actively extended; also known as mallet finger.

Biceps tendinitis — Inflammation of the biceps tendon in its subacromial location

Biomechanics — The study of external and internal forces applied to the body and their relationship to stability and motion.

Bipartite patella — An accessory bony fragment connected to the body of the patella by a line of cartilage.

Bisphosphonates — Potent inhibitors of osteoclasts and bone resorption. May be used to treat osteoporosis and Paget disease.

Body fat percentage (%BF) — The percentage of an individual’s weight that is made up of fat.

Bone densitometry — A procedure used to detect osteopenia in which a special density gradient plate is used to evaluate the comparative density of the spine, femur, or distal radius. Photons from a single- or dual-emitting source are used to measure the density of the bone. These are then compared with normal values for a large patient population based on sex and age.

Bone remodeling — A process that couples bone resorption by osteoclasts with deposition of osteoblasts (new bone cells)

Bone scan — A study used to identify lesions in bone such as fracture, infections, or tumor. A radioisotope is injected into a vein and allowed to circulate through the body. The distribution of radioactivity in the skeleton is measured by a special camera that can detect the emission of gamma rays. Lesions in bone with increased metabolic activity (eg, fracture, tumor, or infection) will show increased uptake of the radioisotope and appear as a dark area in the bone. Also called bone scintigraphy

Boutonnière deformity — Rupture of the central slip of the extensor tendon of the middle phalanx caused by rapid, forceful flexion at the proximal interphalangeal joint; characterized by flexion of the proximal interphalangeal joint and hyperextension of the distal interphalangeal joint.

Bradycardia — Unusually slow, but regular heartbeat.

Brittle — A classification of material that deforms little before failure, such as glass.

Bucket-handle tear — Complete longitudinal tear of the central segment of the meniscus with the torn fragment “flipped” into the joint like the handle of a bucket

Bulla — A blister that is larger than 1 cm.

Bunion — Prominence of the first metatarsal head often associated with lateral shift of the great toe (hallux valgus deformity)

Burner — A neurapraxia from a stretch injury to the brachial plexus; most commonly seen in football players. Also known as a stinger.

Burner (stinger) syndrome — An acute upper trunk brachial plexus injury resulting from head, neck, or shoulder contact in football.

Bursa — A sac formed by two layers of synovial tissue that is located where there is friction between tendon and bone or skin and bone

Bursitis — Inflammation of a bursa

Burst fracture — A compression-type fracture of a vertebra that involves posterior displacement of the fragments, often into the spinal canal

Burst laceration — A facial injury where the skin is compressed against underlying bony prominences at impact and a jagged opening occurs with a variable amount of ischemia and necrosis.

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Café au lait spots — Congenital pigmented skin marks; the color of coffee with milk

Caffeine — A substance found in some food and drinks that stimulates the central nervous system; excess caffeine can cause nervousness, muscular tremors, and heart palpitations.

Calcaneus — Heel bone

Callus — A buildup of the keratin layer from repetitive friction or injury; frequently occurs on the plantar surface of the foot around the great toe.

Calorie (energy) requirement — The calorie intake required to offset calorie expenditure, resulting in a constant body weight.

Cancer — Abnormally growing cells that can invade local tissue, often metastasizing (spreading) to distant areas of the body through the lymphatic system or bloodstream.

Capillaries — Small, thin-walled blood vessels that have close contact with individual cells of the body.

Capsule — A collagenous structure that surrounds a joint like a sleeve. The capsule allows motion of joints and protects the articular cartilage. The capsule, along with ligaments, tendons, and bony structure, provides stability of the joint

Carbohydrate — One of the six classifications of nutrients and one of the three types of energy-yielding nutrients. Carbohydrates are classified by the number of sugar molecules they contain. Carbohydrate loading The practice of maximizing glycogen stores by decreasing training and increasing carbohydrate intake during the week before an endurance event.

Cardiovascular (circulatory) system — A complex arrangement of connected tubes comprising the heart, arteries, arterioles, capillaries, venules, and veins.

Carpal tunnel syndrome — Median nerve compression at the wrist that is characterized by pain, numbness, and weakness in the median nerve distribution of the hand

Carrying angle of the elbow — The angle formed by the long axis of the humerus and ulna, resulting in an abducted position of the forearm relative to the humerus.

Cartilage — A cellular tissue that, in the adult, is specific to joints, but in children forms a template for bone formation and growth. Hyaline cartilage is a low-friction cellular tissue that coats joint surfaces. Fibrocartilage is tough with high collagen content, such as found in the meniscus of the knee, or the anulus fibrosus portion of the intervertebral disk

Cavus — Excessive height of the longitudinal arch of the foot

Cellulitis — Inflammation of subcutaneous tissue. Can be caused by trauma or infection.

Cellulitis — A bacterial infection of the soft tissues that most often occurs after trauma to the skin or prior surgery. Also, a spreading redness and swelling of the skin in response to an insect bite.

Cerebral concussion — The least severe sport-related brain injury that is characterized by immediate and transient impairment of neural functions.

Cerebral contusion — A bruise of the brain substance that may result from an impact of the skull and an object.

Cerebrospinal fluid (CSF) — An almost protein-free fluid that acts as a shock absorber to cushion and protect the brain.

Cervical intervertebral disk herniation — An injury where disk material pushes against or ruptures the annulus fibrosus to impinge against the spinal cord or nerve root.

Cervical lordosis — Forward curvature of the cervical spine.

Charley horse — Muscle soreness and stiffness caused by overstrain or a contusion; also known as a quadriceps contusion.

Chilblain — A local cold injury from repeated, prolonged exposure of bare skin to low temperatures and high humidity, resulting in swollen, tender areas on the fingers and toes.

Cholecystitis — Infection or inflammation of the gallbladder.

Chondroblasts — The cells that form cartilage

Chondrocytes — The cells in cartilage that produce proteoglycans.

Chondroitin sulfate — An important class of glucosaminoglycans in articular proteoglycans; the oral form is thought to prevent degradation of joint cartilage and relieve symptoms

Chondromalacia — Softening of the articular surface that results from exposure of normal cartilage to excessive pressure or shear

Chondrosarcoma — A primary sarcoma formed from cartilage cells or their precursors but without direct osteoid formation

Chronic rotator cuff tear — Tear of the rotator cuff of the shoulder resulting from degeneration within the rotator cuff tendon

Chronic subacromial impingement syndrome — Shoulder pain with active flexion, abduction, and/or internal rotation, but near normal passive range of motion; most commonly found in the senior athlete.

Chronic subluxating patella — A stage in the continuum of patellofemoral dysplasias; the patella partially dislocates out of the intercondylar groove and snaps back into place rather than completely dislocating.

Claudication — A sensation of coolness with pain.

Clavicle — The collarbone

Clavicular epiphyseal fracture — Fracture of the growth plate of the clavicle; may appear clinically as a dislocation, especially if some displacement is present

Closed chest injuries — An injury to the chest in which the skin has not been broken.

Closed fracture — A fracture that does not disrupt the integrity of the surrounding skin

Closed reduction — A procedure to restore normal alignment of a fractured bone or dislocated joint in which the fractured bones are simply manipulated and no incision is needed

Collagen — A triple helix protein that is the major structural macromolecule of the extracellular matrix of articular cartilage; found also in bone, tendon, and ligament

Collagen — A family of stiff, helical, insoluble protein macromolecules that function as scaffolding and provide tensile strength in fibrous tissues and rigidity in bone.

Comminuted fracture — A fracture with more than two fragments

Common peroneal nerve — Nerve lying below the head of the fibula that controls movement at the ankle and supplies sensation to the top of the foot

Compartment syndrome — Ischemia of the nerves and muscles within a fascial compartment caused by elevated pressure within the compartment; frequently seen in association with tibial fractures

Compartment syndrome — A condition that occurs when the amount of swelling and/or bleeding in a muscle compartment causes pressure that is greater than the capillary pressure and results in tissue ischemia and potential tissue necrosis.

Compound fracture — Any fracture in which the overlying skin has been penetrated

Computed tomography (CT, CAT scan) — A radiographic modality that allows cross-sectional imaging from a series of x-ray beams. The x-ray tube is rotated 360° around the patient, and the computer converts these images into a two-dimensional axial image. CT is capable of imaging bone in three planes: coronal, sagittal, and oblique. This modality is particularly useful in evaluating fractures and bone tumors

Conduction — Transfer of heat from the body, which is warmer, to a cooler object such as a cold, wet shirt or an ice pack.

Condyle — A rounded process at the end of a long bone

Congenital spinal stenosis — A syndrome often seen in athletes of short stature or dwarf in which individual vertebrae of the spine may contain short pedicles that decrease the diameter of the spinal canal.

Connective tissue — Tissue that connects and supports the structures of the body

Contact dermatitis — Inflammation of the skin caused by materials or substances coming in contact with it; may involve either allergic or nonallergic mechanisms.

Contusion — Bruise; injury to soft tissue without a break in the skin

Convection — Transfer of heat to the cooler air as air moves across the body surface. The air is warmed and the body is cooled.

Coracoacromial arch — A structure formed by the acromion process and the coracoacromial ligament; comprises the roof over the lateral shoulder.

Coracobrachialis — A muscle that assists in flexion and adduction of the glenohumeral joint.

Coronal plane — A coronal plane is any plane of section in the anatomical position that passes vertically through the body and is perpendicular to the median plane. It divides the body into anterior and posterior sections.

Cortical bone — Dense bone that is responsible for skeletal homeostasis Corticosteroids Cortisone-like medicines that are used to provide relief for inflamed areas of the body. They lessen swelling, redness, itching, and allergic reactions. Often used for a number of other diseases such as asthma or other auto immune diseases.

Costal arch — Fused costal cartilages of the sixth to tenth ribs forming the upper border of the abdomen

Costovertebral angle — Angle that is formed by the spine and the tenth rib; the kidneys lie beneath the back muscles in the costovertebral angle

COX-1 — Cyclooxygenase-1 enzyme; an enzyme that is present in most bodily tissues (including platelets and gastrointestinal mucosal tissues) and serves as a “housekeeping” enzyme to form prostaglandins

COX-2 — Cyclooxygenase-2 enzyme; an enzyme that is thought to be present in the body only when induced in response to injury and is responsible for the formation of prostaglandins that mediate pain and inflammation

Coxa magna — A deformity of the hip in which the ball of the hip joint is enlarged. May be secondary to Legg-Perthes disease or arthritis.

Coxa valgus — A valgus or abduction deformity of the hip. The neck/shaft angle in increased.

Cranial bones — Eight bones of the skull that protect the brain; include the frontal bone, two parietal bones, two temporal bones, occipital bone, sphenoid bone, and ethmoid bone.

Cranial nerves — Twelve pairs of special nerves that are associated with various sensory and motor functions.

Creatine — A nutritional supplement used to increase anaerobic power and strength.

Creep — Continued deformation of soft tissue in response to a maintained load.

Crepitus — A grating or grinding sound

Crush injury — An injury produced as a result of continuous pressure applied to a part of the body, usually an extremity

Cryotherapy — The therapeutic use of cold

Curettage — The removal of growths from within cavity walls; in the treatment of musculoskeletal tumors, the scraping of tumor out of bone

Cystogram — A procedure in which the bladder is filled with a radiographic contrast agent and a radiograph is obtained, followed by a second radiograph after the contrast agent has been drained; used to determine bladder injuries.

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Deep venous thrombosis (DVT) — Venous clot formation caused by immobilization, hypercoagulation, obstructed venous flow, or endothelial injury, among others

Deformation — The amount of lengthening or shortening in a structure divided by the structure’s original length.

Degenerative joint disease (DJD) — Deterioration of the articular cartilage that lines a joint, which results in narrowing of the joint space and pain; osteoarthritis

Dehydroepiandrosterone (DHEA) — An adrenal hormone that is a metabolic precursor for the production of testosterone, estrogen, and other hormones. Sold as an over-the-counter nutritional agent that is sometimes used as a substitute for anabolic steroids or testosterone to decrease fat mass and increase muscle mass.

Delayed-onset muscle soreness (DOMS) — Muscle pain or discomfort that follows unaccustomed vigorous exercise and persists for several days despite the cessation of activity.

Delayed union — A delay in normal fracture healing; not necessarily a pathologic process

Depolarization — A change in electricity in the heart caused by an electrical impulse and resulting in contraction of individual myocardial cells.

Dermatitis — Inflammation of the skin that encompasses a broad range of disorders; usually appears as an itchy area of redness or scaling.

Dermis — The layer of skin that contains connective tissue and gives skin elasticity and strength.

Diabetes — A metabolic disorder characterized by hyperglycemia caused by defects in insulin secretion, insulin action, or both.

Diaphysis — The shaft of a long bone.

Diarthrodial joint — A specialized articulation in the acromioclavicular capsule that permits free movement.

Diastasis — Separation of the distal tibia and fibula.

Diastole — Relaxation of the heart muscle.

Discography (diskography) — A procedure in which a radiopaque material is injected into a lumbar or cervical intervertebral disk to outline the disk. This procedure used in conjunction with CT to help identify the source of back pain. The pain produced by the injection is correlated with the patient’s symptoms.

Discoid meniscus — A congenital deformity in young athletes in which the meniscus is discoid in shape rather than semilunar.

Diskectomy — A surgical decompression procedure in which an intervertebral disk is removed

Dislocation — Complete disruption in the normal relationship of two bones forming a joint (ie, no contact of the articular surfaces). The direction of the dislocation is described by the position of the distal bone (eg, with an anterior dislocation of the shoulder, the humerus is displaced anterior to the scapula).

Displaced fracture — A fracture that produces deformity of the limb

Distal — Location in an extremity nearer the free end; location on the trunk farther from the midline or from the point of reference

Distraction — A separation of joint surfaces with no dislocation or ligament rupture.

Dorsal — Toward the posterior surface of the body

Dual-energy x-ray absorptiometry (DEXA or DXA) — A diagnostic imaging technology that uses two different x-ray voltages to assess bone density

Ductile — A classification of material that deforms extensively before failure, such as soft metal.

Dura mater — The outermost tough fibrous membrane that lies immediately inside the bone as part of the meninges.

Dynamic stabilization — The use of muscle strength and muscle coordination during performance of activities; used in rehabilitation.

Dynamic strength — The magnitude of isotonic or isokinetic contraction

Dysplasia — A broad term that describes a condition affecting growth or development in which the primary defect is intrinsic to bone or cartilage

Dyspnea — A state of difficult or labored breathing that results from either trauma or disease.

Dystrophy — A condition resulting from defective or faulty nutrition, broadly construed to include nourishment of tissue by all essential substances, including those normally manufactured by the body itself

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Eccentric exercises — Exercises in which the muscle lengthens despite resisting a force, as in slowly lowering a weight

Ecchymosis — Bruising or discoloration associated with bleeding within or under the skin

Edema — Condition in which fluid escapes into the tissues from vascular or lymphatic spaces and causes local or generalized swelling

Effusion — The presence of fluid within a joint

Electrical muscle stimulation (EMS) — Treatment in which the biphasic current delivers stimulation to muscles in a variety of ways, including pulse, surged, or tetanizing contractions

Electrocardiogram (EKG) — A recording of electrical currents that flow through the heart in the form of a series of waves and complexes that are separated by regular intervals.

Electromyography (EMG) — A test that measures the electrical response of muscle contraction

Enchondral bone healing — Process in which capillaries grow among mesenchymal cells, forming a fibrovascular tissue known as callus that bridges the gap between bone ends

Enchondral ossification — The process of long bone formation where the cartilage model is replaced by bone.

Endochondral ossification — The formation of bone within a cartilage model

Endoneurium — A fibrous tissue that coats axons.

Epidermis — The layer of skin that protects against ultraviolet damage and provides cutaneous immunity.

Epidural hematoma — A blood clot located outside the dura mater.

Epinephrine — An agent that rapidly produces bronchodilation to reverse the effects of an allergen on a patient’s airway.

Epiphyseal line — The part of a long bone that produces growth

Epiphysis — A part of a long bone developed from a center of ossification distinct from that of the shaft and separated at first from the latter by a layer of cartilage.

Epitenon — A glistening, synovial-like membrane that envelops the tendon surface.

Erythematous — Redness of the skin.

Ewing sarcoma — A primary sarcoma of the bone that usually arises in the diaphyses of long bones, ribs, and flat bones of children and adolescents

Exostosis — A spur or bony overgrowth.

Extension — Movement of an extremity posterior to or behind the body.

Extensor — A muscle, the contraction of which causes movement at a joint with the consequence that the limb or body assumes a more straight line, or so that the distance between the parts proximal and distal to the joint is increased or extended; the antagonist of a flexor

Extensor mechanism — Complex interaction of muscles, ligaments, and tendons that stabilizes the patellofemoral joint and acts to extend the knee

External fixation — Stabilization of a fracture or unstable joint by inserting pins into bone proximal and distal to the injury that are then attached to an external frame.

External rotation — Lateral rotation of an extremity relative to the body.

Exudate — A liquid product that has escaped from blood vessels and been deposited in tissue as a result of inflammation.

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Fascia — Sheet or band of tough fibrous connective tissue; lies deep under the skin and forms an outer layer for the muscles

Fast twitch fibers — The speed of contraction of type II muscle fibers. Fast twitch muscle fibers Type II muscle fibers. Fat embolism syndrome Respiratory distress and cerebral dysfunction caused by droplets of marrow fat released at a fracture site and deposited in the lungs or brain

Fatigue fracture — Microfracture that occurs when the bone is subjected to frequent, repeated stresses, such as in running or marching long distances, and the rate of bone breakdown exceeds the rate of bone repair.

Fat pad — Specialized soft tissue structure for weight bearing and absorbing impact Felon Infection of the pulp of the distal phalanx of the finger.

Female athlete triad — The constellation of abnormal or absent menses, eating disorders, and osteoporosis/stress fractures seen in female athletes

Female athlete triad — The result of behavior that affects female athletes and consists of disordered eating, amenorrhea, and osteoporosis.

Fibrocartilage — A mesh of collagen fibers, proteoglycans, and glycoproteins, interspersed with fibrochondrocytes.

Fibrochondrocytes — Cells that are able to synthesize fibrous extracellular proteins and have the rounded appearance of chondrocytes

Fibrositis — Diffuse pain in multiple sites that does not result from trauma and is associated with emotional disturbances.

Fibrous scar — The typical patching material for wound repair. Fibular collateral ligament Ligament that inserts from the femoral condyle to the fibular head

Fibular stress fracture — A fracture usually located a few centimeters above the ankle joint as the result of repetitive loads on the bone that cause an imbalance of bone resorption over formation.

Flail chest — A fracture of at least four consecutive ribs in two or more places; the most serious of chest wall injuries.

Flexion — Movement of an extremity anterior to or in front of the body.

Flexor — A muscle the action of which is to flex or bend a joint

Floating ribs — The eleventh and twelfth ribs, which do not connect to the sternum

Fluoroscopy — A special type of radiograph that shows continuous motion of the structure, such as wrist motion

Foramen — The space between the pedicles of two adjacent vertebrae through which the nerve root exits at each level in the cervical spine.

Fracture — A disruption in the integrity of a bone

Fracture callus — Bone developed after a fracture; initially formed from a hematoma at the bleeding edges of bone, it eventually forms a cartilage mass that is remodeled into mature bone

Fracture-dislocation — A fracture of bone associated with a dislocation of its adjacent joint. Fracture reduction The realignment of fracture fragments to restore normal anatomy of the bone

Freiberg’s disease — An osteochondrosis or osteonecrosis of the metatarsal head.

Frozen shoulder — A condition characterized by restricted shoulder movement resulting from acute trauma or a periarticular biceps or rotator cuff tendon injury.

Fusion (arthrodesis) — The joining of two bones into a single unit, thereby obliterating motion between the two. May be congenital, traumatic, or surgical.

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Galeazzi fracture — Dislocated ulna with a fractured radius

Ganglion — A mass of nerve cell bodies usually found lying outside the central nervous system

Gastrocnemius-soleus strain — An injury that involves the medial side of the complex; symptoms include sudden pain with a popping sensation in the calf, followed by swelling and ecchymosis; also known as tennis leg.

Gerdy’s tubercle — The attachment site for the iliotibial band.

Glenohumeral dislocation — Injury in which the humeral head may displace from the joint; most of these dislocations are anterior and inferior to the glenoid rim

Glenoid labrum — A soft fibrous rim surrounding the glenoid fossa that deepens the socket and provides stability for the humeral head.

Glenoid labrum tear — Tear of the glenoid labrum; can result from acute trauma or overuse

Glucosamine sulfate — A fundamental component in the synthesis of both hyaluronic acid and chondroitin that is thought to promote cartilage repair and synthesis; the oral form is taken as a dietary supplement to treat arthritis

Gout — An inflammatory arthritis associated with deposition of urate in the joint

Greenstick fracture — A fracture that disrupts only one side of the bone. This fracture pattern is seen in children because of the greater plasticity of their bones.

Ground strike — A type of lightning strike in which the lightning hits the ground first and travels along the ground to the individual.

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Head — The upper or proximal portion of a structure; the head of a bone is the rounded end that allows joint rotation

Hemarthrosis — A collection of blood within a joint.

Hematoma — A collection of blood resulting from injury

Hemiplegia — Paralysis of one side of the body. Herniated disk Rupture of the nucleus pulposus or anulus fibrosus of the intervertebral disk

Heterotopic ossification — The formation of bone in any nonosseous tissue; often occurs following trauma

Hill-Sachs lesion — An indentation or compression fracture of the posterior superolateral articular surface of the humeral head that is created by the sharp edge of the anterior glenoid as the humeral head dislocates over it.

Hydroxyapatite — The mineral component of bone matrix that is deposited into the organic framework to make the bone hard and strong.

Hypermobility — An increase in normal motion.

Hypomobile facet — A painful dysfunction where a facet of the vertebral body becomes “locked.”

Hysteresis — The amount of relaxation, or variation in the load-deformation relationship, that takes place within a single cycle of loading and unloading in soft tissue.

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ICES — Ice, compression, elevation, and splinting

Iliotibial band (ITB) syndrome — An overuse injury where repetitive flexion and extension causes inflammation of the iliotibial band when it rubs over the lateral femoral condyle.

Immune hyperplasia — An increase in activity of the spleen. Impacted fracture A fracture pattern in which the fragments are pushed together, thus imparting some stability.

Impetigo — A contagious skin condition in which flaccid crusts and blisters cluster in involved areas, most commonly around the mouth.

Impingement syndrome — Shoulder pain caused by tendinosis of the rotator cuff tendon or irritation of the subacromial bursa. See also Rotator cuff impingement, external, and Rotator cuff impingement, internal

Inflammation — A localized tissue response initiated by the injury or destruction of vascularized tissues.

Inflammation — Heat, redness, swelling, and pain that accompany musculoskeletal injuries; occurs when tissue is crushed, stretched, or torn

Instability — Looseness, unsteadiness, or an inability to withstand normal physiologic loading without mechanical deformation.

Internal fixation — Surgical insertion of a device that stops motion across a fracture or joint to encourage bony healing or fusion

Internal rotation — Medial rotation of an extremity relative to the body.

Intervertebral disk — A fibrocartilaginous disk located between the bodies of each of the vertebrae.

Intramedullary nailing or rodding — A procedure for the fixation of fractures in which a nail or rod is inserted into the intramedullary canal of the bone from one of its two ends

Intramembranous ossification — Bone formation characterized by the aggregation of undifferentiated mesenchymal cells, which differentiate into osteoblasts

Intramembranous ossification — The growth of bone without a cartilage model.

Iontophoresis — The administration of medication through the skin by direct electrical current. Ischemia Tissue deprived of a blood supply.

Isokinetic — Literally, “same speed”; when applied to muscle action, it implies constant velocity of shortening

Isokinetic exercise — In isokinetic contractions, the muscle contracts and shortens at constant speed.

Isometric — Literally, “same length”; when applied to muscle action, it implies that the muscle length is held constant even with varying loads. Accomplished by contracting the flexors and extensors of a joint at equal loads so that the joint does not move.

Isotonic — When applied to muscle action, the condition when a muscle shortens against a constant load, as in lifting a weight Isotonic exercise Contraction of muscles concentrically or eccentrically against resistance with movement of the part so that the load remains constant

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Joint — The junction between the ends of two adjacent bones.

Joint capsule — A thin, but strong structure in the elbow that plays a role in ligamentous restraint.

Joint manipulation — Skilled, passive movement of a joint (or spinal segment) either within or beyond its active range of motion; also known as joint mobilization.

Joint mobilization — Passive movement techniques used to treat joint dysfunctions such as stiffness, reversible joint hypomobility, and pain.

Joint play — Capsular laxity that allows movement at the joint that may be demonstrated passively, but cannot be actively performed by the patient; used in joint mobilization.

Jones fracture — Stress fracture of the proximal shaft of the fifth metatarsal; a fracture that frequently heals with difficulty

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Kaposi’s sarcoma — A neoplasm seen in AIDS patients in the form of a malignancy of the skin.

Kenny Howard splint — A type of splint used to reduce any significant displacement in the treatment of an epiphyseal fracture of the clavicle.

Ketoacidosis — A form of acidosis (accumulation of acids in the body) in uncontrolled diabetes in which accumulation of certain acids occurs as the result of unavailable insulin.

Ketones — Organic substances in the urine that are derived from fat metabolism. Presence in the urine indicates that exercise should be cancelled for the day.

Kinematics — The study of the movement of rigid structures without reference to the cause of motion, ie, independent of the forces that produce it.

Kinesiology — The study of motion of the human body. Kinesthesia A term used to define the body’s ability to detect positional changes.

Kinetic energy (KE) — The energy of a moving body; equals one half the mass times the square of the velocity.

Kinetics — The study of the forces that produce movements.

Klippel-Feil anomaly — A condition where there is congenital fusion of two or more vertebrae; participation in contact sports depends on numerous factors and requires extensive evaluation.

Kohler disease — Osteochondrosis of the tarsal navicular

Kyphosis — Curvature of the spine that is convex posteriorly

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Lachman test — A test to confirm integrity of the anterior cruciate ligament of the knee.

Lamellar — Mature layered bone.

Lamellar bone — Mature, well-organized form of cortical bone

Laminectomy — A surgical decompression procedure in which part of the posterior arch of a vertebra is removed; allows access to the disk

Lateral — Lying away from the midline

Lateral articular surface — A bony process on each end of the clavicle.

Lateral condyle — Forms the lateral border of the upper surface of a joint

Lateral epicondylitis — Inflammation of the lateral epicondyle; also known as tennis elbow.

Lateral malleolus — Bony prominence at the end of the fibula that is part of the ankle joint

Lateral meniscus — The lateral C-shaped fibrocartilaginous structure of the knee

Lateral patellar compression syndrome (LPCS) — The mildest form of patellofemoral dysplasia with some degree of malalignment.

Lateral view — A view that passes from side to side at 90° to an AP or PA view

Lavage — The irrigation or thorough washing of an infected joint with high-volume saline solution

Legg-Calvé-Perthes disease — Osteonecrosis of the proximal femoral epiphysis that most commonly affects boys aged 3 to 8 years.

Leukocytes — White blood cells that migrate toward increasing concentrations of mediators at the site of injury.

Ligament — A collagenous tissue that connects two bones to stabilize a joint

Lisfranc fracture — A fracture-dislocation of the tarsometatarsal joint Load Any force or combination of forces applied to the outside of a structure.

Load-deformation curve — The mathematical relationship of the load applied to a structure; used to determine the strength and stiffness of a structure.

Loose-packed position — The position in which a joint capsule is most relaxed and the greatest amount of joint play is possible.

Lordosis — Curvature of the spine that is convex anteriorly

Low-molecular-weight heparins (LMWHs) — Anticoagulants that work by binding to antithrombin-III and catalyze its inactivation of factor Xa

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Magnetic resonance imaging (MRI) — An imaging modality that depends on the movement of protons in water molecules. When subjected to a magnetic field, protons that are normally randomly aligned become aligned. Radiowaves directed at the tissue to be studied are used to change the alignment of these photons. When the radiowaves are turned off, the protons emit a signal that is detected and processed by a computer into an image. In the musculoskeletal system, MRI is useful in diagnosing soft-tissue injuries, tumors, stress fracture, and infection.

Malunion — Healing of a fracture in an unacceptable position

Marfan’s syndrome — A rare genetic disorder that is inherited as an autosomal dominant condition in which connective tissue is affected, weakening the aorta and causing an aneurysm or rupture of the aorta.

Mechanism of injury — A representation of the patterns of energy that cause traumatic injuries

Medial — Lying toward the midline

Medial articular surface — A bony process on each end of the clavicle.

Medial collateral ligament injuries — An acute knee injury that is the result of a blow to the lateral side of the knee when the foot is planted; commonly seen in football players and snow skiers.

Medial condyle — Forms the medial border of the upper surface of a joint

Medial epicondyle — A bony prominence located proximal and medial to the trochlea; serves as the attachment site for the flexor-pronator muscle group and the ulnar collateral ligament.

Meniscus — A soft-tissue structure that lines some joints and provides load distribution, shock absorption, and lubrication.

Mesenchymal syndrome — A subset of sports trauma patients who are at risk for connective tissue breakdown following relatively benign load or use.

Metacarpals — The five bones of the hand that extend from the wrist to the fingers.

Metaphysis — The broad portion of a long bone adjacent to a joint. In children, the broad portion of a long bone includes the epiphysis, the physis, and the metaphysis.

Metaphysis — The flare at either end of a long bone.

Metastasis — The transfer of disease from one part of the body to another; tumor metastasis usually occurs via the bloodstream or the lymphatic system

Microtrauma — Destruction of a small number of cells caused by additive effects of repetitive forces

Midline — Imaginary straight vertical line drawn from midforehead through the nose and the umbilicus to the floor

Modalities — Physical agents that can create an optimum environment for injury healing, while reducing pain and discomfort

Monteggia fracture — Dislocation of the radial head in association with an ulnar fracture

Multidirectional instability (MDI) — Symptomatic glenohumeral instability in more than two directions.

Muscles — Contractile connective tissues that affect movement; a component of nearly all organs and body systems.

Mycoplasma — One of five types of microorganisms that commonly causes disease, characterized by a single cell and with no rigid cell wall. Mycoplasma are similar to bacteria.

Myelography — A radiographic study in which a water-soluble contrast agent is injected into the subarachnoid space to form a column of opacified fluid that outlines the thecal sac of the spinal cord. Used to assess herniated disks and spinal stenosis. This study has been largely replaced by MRI and CT.

Myelopathy — An abnormal condition of the spinal cord, whether through disease or compression. The usual consequences are spasticity, impairment of sensation, and impairment of bowel and bladder function.

Myoblasts — The embryonic cells that develop into skeletal muscle cells

Myocardial contusion — Bruising of the heart muscle.

Myocardial infarction — Heart attack resulting from blockage of the major coronary vessels and lack of oxygen to the myocardium, causing permanent damage to or death of the heart muscle.

Myofascial pain syndrome — A painful musculoskeletal response following muscle trauma.

Myofibers — The fibers that constitute a muscle

Myofibrils — A slender thread within a muscle fiber that functions in muscle contraction

Myoglobin — A protein that serves as a storage site for oxygen and speeds the diffusion of oxygen into muscle fibers.

Myopathies — A wide and varied group of primary muscle disorders characterized by weakness

Myositis ossificans — The formation of lamellar bone within muscle, often as a result of blunt trauma.

Myotomes — The areas of muscle that are supplied by a particular nerve root.

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Navicular bone — Bone with which the head of the talus articulates on the medial side of the foot; also a bone in the wrist that articulates with the trapezium, trapezoid, and other carpal bones

Navicular stress fracture — A fracture that occurs with repetitive stress activities and results in medial foot pain and tenderness over the dorsal navicular.

Neck — The constricted portion of a structure (eg, femoral neck)

Nerve conduction studies — Studies that test the speed by which motor, sensory, or mixed (combined motor and sensory) nerves transmit impulses

Neuralgia — Pain along the course of a nerve

Neurapraxia — A temporary loss of neural function

Neuritis — Inflammation or irritation of a nerve

Neuroma — A tumor composed of nerve cells

Neuropathic arthritis — The chronic, progressive destruction of a joint that is caused by the loss of sensation from an underlying neurologic dysfunction; also known as Charcot arthropathy

Neuropathy — An abnormal condition involving a peripheral nerve

Neurotmesis — A grade V injury in which there is complete nerve disruption leading to the death of the distal axons and wallerian degeneration of myelin.

Neurotoxic — A substance poisonous to nerve tissue.

Neutrophils — A type of granular leukocyte.

Nocioceptive — Pain-sensing

Nondisplaced fracture — Fracture in which there is no deformity of the limb

Nonossifying fibromas — Osteolytic and sometimes painful proliferative lesions composed of spindle (fibrous) cells

Nonsteroidal anti-inflammatory drugs (NSAIDs) — A broad group of chemically heterogeneous drugs that share important clinical and tissue effects: all have some analgesic, antipyretic, and anti-inflammatory activity. Includes aspirin, ibuprofen, indomethacin, naproxen, and others.

Nonunion — Failure of healing of a fracture or osteotomy. With continued motion through a nonunion, a pseudarthrosis will form

Nucleus pulposus — A region of the intervertebral disk that functions as a shock absorber against axial loads.

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Oblique fracture — A fracture in which the fracture line crosses the bone diagonally

Odontoid anomalies — A developmental malformation that can lead to instability between C1 and C2; considered an absolute contraindication for contact sports.

Olecranon bursa — Bursa in the elbow that separates the skin from the underlying ulna; allows the soft tissue to glide smoothly over the olecranon process

Open reduction — An open surgical procedure in which normal or near-normal relationships are restored to a fractured bone or dislocated joint

Open reduction and internal fixation (ORIF) — A procedure that involves incising the skin and soft tissue to repair a fracture under direct visualization

Origin — The more fixed end or attachment of a muscle

Osgood-Schlatter disease — Partial avulsion of the tibial tubercle because the tubercle is subjected to traction forces by the patellar tendon insertion; also known as tibial osteochondrosis.

Osteoarthritis (OA) — A deterioration of the weightbearing surface; distinguished by destruction of the hyaline cartilage and narrowing at the joint space.

Osteoblasts — Cells that form new bone.

Osteochondral fractures — Injuries that disrupt articular cartilage and the underlying subchondral bone

Osteochondritis dissecans (OCD) — A localized abnormality of a focal portion of the subchondral bone, which can result in loss of support for the overlying articular cartilage

Osteoclasts — Bone-resorbing cells.

Osteocytes — The cells of established bone

Osteogenesis imperfecta — A hereditary disorder of connective tissue caused by mutations in the gene for type I collagen

Osteoid — The organic matrix of bone; a protein framework composed of collagen that allows growth and remodeling.

Osteoid osteoma — A small, benign, but painful tumor usually found in the long bones or the posterior elements of the spine

Osteokinematic motions — Vertebral motion associated with range of motion; includes flexion, extension, rotation, and lateral flexion in the lumbar spine.

Osteolysis — Dissolution of bone, particularly as resulting from excessive resorption

Osteomyelitis — Infection of bone, either bacterial or mycotic

Osteon — In lamellar bone, a concentric series of layers of mineralized matrix surrounding the central canal.

Osteonecrosis — The death of bone, often as a result of obstruction of its blood supply

Osteopenia — Bone fragility as the result of a low-calcium diet.

Osteoperiostitis — A painful inflammation of the periosteum or lining of bone.

Osteophytes — Overgrowth of bone, common in osteoarthritis and spinal stenosis

Osteoporosis — Deterioration of bone tissue resulting in an increased risk of fracture as the result of a low-calcium diet.

Osteosarcoma — A primary sarcoma of the bone that is characterized by the direct formation of bone or osteoid tissue by the tumor cells

Osteosynthesis — The process of bony union, as in fracture healing. It is a biologic welding process that is sometimes facilitated with grafts of bone from the iliac crest and insertion of fixation devices

Osteotomy — Literally, cutting a bone. Used to describe surgical procedures in which bone is cut and realigned

Overload principle — A principle that states that strength, power, endurance, and hypertrophy of muscles increase only if muscles perform workloads that are greater than those previously encountered.

Overuse injury — Any injury caused by repetitive submaximal stress that surpasses the tissue’s natural repair processes.

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Paget disease — A condition of abnormally increased and disorganized bone remodeling

Palmar — The anterior surface of the forearm, wrist, and hand

Panner disease — Osteonecrosis of the capitellum seen in teenagers

Pannus — A proliferation of synovium beginning at the periphery of the joint surface as seen in rheumatoid arthritis

Papule — A raised lesion in the skin that is less than 1 cm in diameter.

Parasympathetic (craniosacral) nervous system — A part of the autonomic nervous system that causes blood vessels to dilate, slows the heart rate, and relaxes muscle sphincters

Paratenon — A loose areolar tissue that surrounds the epitenon in tendons that move in a straight line and are capable of great elongation.

Paresthesias — Abnormal sensations such as tingling, burning, or prickling

Pathologic fracture — A fracture caused by a normal load on abnormal bone, which is often weakened by tumor, infection, or metabolic bone disease

Percutaneous pinning — Insertion of pins into bone through small puncture wounds in the skin for stabilization of a fracture or a dislocated joint that was realigned by closed reduction.

Perineurium — A connective tissue that covers individual fascicles.

Periosteum — A sleeve of connective tissue that surrounds the shaft of the bone and contributes to fracture healing

Periostitis — Inflammation of the periosteum.

Peripheral obesity — The location of excessive body fat resulting in a pear shape; not associated with serious cardiovascular complications.

Peritendinitis — Inflammation of the tendon sheath, marked by pain, swelling, and, occasionally, local crepitus

Peritendon — A structure composed of the epitenon and the paratenon.

Peritonitis — Contamination of the peritoneum or peritoneal cavity by the bacteria-laden contents of a ruptured bowel.

Peroneal tendon injuries — A classification of injuries that includes tendinitis, acute and chronic dislocations, longitudinal tears, and tendon ruptures.

Phagocytosis — The process by which white blood cells ingest debris or microorganisms

Phonophoresis — The transdermal introduction of a topically applied medication (usually either an anti-inflammatory or analgesic) into soft tissue using ultrasound

Phonophoresis — The administration of medication through the skin by ultrasound.

Physis — The growth plate. Specialized cartilaginous tissue interposed between the metaphysis and epiphysis in long bones in children. Provides growth in length of the bone.

Pigmented villonodular synovitis — A proliferative process of the synovial membrane of unknown etiology

Portable transcutaneous electrical nerve stimulation (TENS) unit — A portable therapeutic modality that uses electrical stimulation to attempt to modulate pain, strengthen muscles, and enhance soft-tissue healing

Posterior arch — The posterior division of the vertebral column that includes the facet joints on either side of the arch and the posterior spinous process.

Posterior glenohumeral dislocation — Disruption of the glenohumeral joint in a posterior direction

Posterior process — That part of each vertebra that can be palpated, as it lies just under the skin in the midline of the back

Posterior sternoclavicular dislocation — Disruption of the sternoclavicular joint posteriorly

Posterior tibial syndrome — Pain along the posterior medial border of the tibia; thought to be secondary to a tight posterior tibial muscle “pulling” on the periosteum in this area; associated with running

Posterolateral rotatory instability — The lateral tibial plateau rotates posteriorly in relationship to the femur

Posttraumatic arthritis — A form of secondary osteoarthritis caused by a loss of joint congruence and normal joint biomechanics

Preparticipation physical examination — A physical examination held prior to participation in an organized sport that can lay a foundation for the team physician and athletic trainer in an athlete’s future care.

Progressive resistance exercise (PRE) — A type of strengthening exercise based on a 10-repetition maximum that overloads muscle in a progressive, gradual manner that avoids overtraining and fatigue.

Proprioception — A sense or perception, usually at a subconscious level, of the movements and position of the body and especially its limbs, independent of vision; this sense is gained primarily from input from sensory nerve terminals in muscles and tendons (muscle spindles) and the fibrous capsule of joints combined with input from the vestibular apparatus

Proteoglycans — Complex macromolecules that consist of a protein core with covalently bound polysaccharide (glycosaminoglycan) chains

Proximal — Describing structures that are closer to the trunk

Pseudarthrosis — A false joint produced when a fracture or arthrodesis fails to heal

Pseudofractures — Lines of radiolucency that represent stress fractures with unmineralized osteoid

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Quadriceps angle (Q angle) — An angle formed by the intersection of two lines: one line is drawn from the anterosuperior iliac spine to the midpatella; the second is drawn from the midpatella to the anterior tibial tuberosity. These lines parallel the quadriceps and patellar tendons.

Quadriceps tendinitis — A condition that results in tendon insertion pain just proximal to the patella; commonly occurs in running and jumping sports that involve changing directions.

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Radial fossa — A depression that lies immediately above the capitellum on the anterior aspect of the humerus.

Radiculopathy — Disease of the nerve roots.

Range of motion (ROM) — The amount of movement available at a joint

Referred pain — Pain that is perceived in a different location from the location of pathology.

Regeneration — The production of tissue that is structurally and functionally identical to tissue damaged by injury.

Rehabilitation — Restoration, following disease, illness, or injury, of the ability to function in a normal or near-normal manner

Repair — The replacement of damaged or lost cells and matrix with new cells and matrix that are not necessarily identical in structure and function to normal tissue.

Resection arthroplasty — A procedure in which the surfaces of diseased bone are excised, allowing fibrocartilage to grow in its place

Revascularization — A procedure to provide an additional blood supply to fractured bone

Reversibility — The concept that a muscle will atrophy from disuse and detrain if not consistently trained toward a set goal.

Rhabdomyolysis — Excessive muscle breakdown.

Rheumatoid arthritis — A chronic inflammatory disease that is probably triggered by an antigen-mediated inflammatory reaction against the synovium in the joint

RICE — A method of treatment of acute injury that is used to counteract the body’s initial response to injury; RICE is an acronym for rest, ice, compression, and elevation

Rickets — The childhood form of osteomalacia

Rotator cuff — The rotator cuff is made up of four muscles and their tendons. These combine to form a “cuff” over the head of the humerus. The four muscles-the supraspinatus, infraspinatus, subscapularis, and teres minor-originate from the scapula and together form a single tendon unit that inserts on the greater tuberosity of the humerus. The rotator cuff helps to lift and rotate the arm and to stabilize the ball of the shoulder within the joint.

Rotator cuff impingement, external — Impingement of the rotator cuff on the acromion and the coracoacromial ligament; causes microtrauma to the cuff, resulting in local inflammation, edema, cuff softening, pain, and poor function of the cuff

Rotator cuff impingement, internal — A condition in the shoulder of throwing athletes that results in tears of the underside of the rotator cuff and the posterior labrum

Rotator cuff muscles — Muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) that act in concert to steer or rotate the proximal humerus.

Rotator cuff tear — An injury of the rotator cuff that is described as acute or chronic and partial or full thickness; also classified by estimated size.

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Scapulothoracic joint — Articulation in which the scapula is suspended from the posterior thoracic wall through muscular attachments to the ribs and spine

Scheuermann disease — Osteochondrosis of the vertebral epiphysis resulting in increased thoracic kyphosis in the preteen and early adolescent years

Schwann cell — A specialized support cell that encases nerve fibers

Scintigraphy — Another name for nuclear scan such as a bone scan.

Sclerotic — Hardening, as in margins along a fracture line in bone.

Scoliosis — Lateral curvature of the spine

Secondary bone healing — The repair process that is characterized by the formation of fracture callus, which then remodels to form new bone

Secondary osteoarthritis — Osteoarthritis resulting from known precipitants such as bone ischemia, trauma, and neuropathy

Secondary osteoporosis — Osteoporosis characterized by conditions in which bone is lost because of the presence of another disease, such as hormonal imbalances, malignancies, or gastrointestinal disorders, or because of corticosteroid use Second-degree burns Partial-thickness burns that extend down to the dermis; characterized by painful blistering of the skin

Seizure — Results of abnormal and excessive discharge from a set of neurons in the brain ranging from blanking out to generalized uncoordinated muscle activity.

Septic arthritis — Infection of a joint, either bacterial or mycotic

Sesamoiditis — Acute or chronic inflammation of the sesamoid.

Shaft — The long, straight, cylindrical midportion of a bone

Shearing stress — One of three stresses generated in a brain injury; involves a force that moves across the parallel organization of tissue.

Shear strain — The amount of angular deformation in a structure or change in the original angle of the structure in response to torque loading.

Sinding-Larsen-Johanssen syndrome — Overuse traction apophysitis caused by repetitive microtrauma at the insertion point of the proximal patellar tendon onto the lower patellar pole; also known as patellar osteochondrosis.

Skeletal (voluntary) muscle — Striated muscles that are attached to bones and usually cross at least one joint

SLAP (Superior Labral, Anterior to Posterior) lesion — An injury to the biceps tendon anchor and/or superior labrum.

Slipped capital femoral epiphysis — A unique fracture of the femoral epiphysis that fractures through the epiphysis and shifts; commonly occurs in adolescents.

Smooth muscle — Nonstriated, involuntary muscle that constitutes the bulk of the gastrointestinal tract and is present in nearly every organ to regulate automatic activity

Snapping scapula — A sensation of snapping as the scapula glides against the chest wall.

Spinal column — Central supporting bony structure of the body; vertebral column

Spinal cord — Extension of the brain, composed of virtually all the nerves carrying messages between the brain and the rest of the body. It lies inside of and is protected by the vertebrae and the spinal column

Spinal stenosis — Developmental narrowing of the cervical spine.

Spinal stenosis — Narrowing of the canal housing the spinal cord; commonly caused by encroachment of bone

Spine — Column of 33 vertebrae extending from the base of the skull to the tip of the coccyx

Spinoglenoid — A structure located at the base of the scapular spine and formed by the convergence of the scapular spine with the glenoid and the coracoid processes; also known as the greater scapular notch.

Spinous processes — Palpable prominences in the vertebrae

Spiral fracture — A fracture caused by a twisting force that results in a helical fracture line

Splint — Device used to immobilize part of the body

Spondylolisthesis — Displacement of one vertebra on another through the spondylitic defect of the pars interarticularis.

Spondylolysis — A defect (possibly a type of stress fracture) in the pars interarticularis of the vertebrae. Also, an overuse injury to the pediatric athlete’s spine, most frequently the lumbosacral spine, in which the athlete reports an insidious, nontraumatic onset that lasts longer than 3 weeks.

Sprain — Partial or complete tear of a ligament

Spur formation — Degenerative and age-related changes in the neck where spurs form along the vertebral end plates in an attempt to autostabilize vertebral motion.

Stenosis — A stricture of any canal or orifice. In the spine, a narrowing of the spinal canal secondary to a combination of disk narrowing, thickening of the ligamentum flavum, and osteophytes from arthritis of the facet joints.

Sternum — Breastbone

Stinger — A neurapraxia from a stretch injury to the brachial plexus; most commonly seen in football players. Also known as a burner.

Strain — Deformation in a structure under loading. Partial tear of a muscle

Stress — The load per unit area that develops on a plane surface within a structure in response to externally applied loads.

Stress fracture — An overuse injury in which the body cannot repair microscopic damage to the bone as quickly as it is induced, leading to painful, weakened bone

Subcutaneous fat — The layer of skin that insulates and protects the body. Subdural hematoma A blood clot located beneath the dura mater.

Subluxation — An incomplete disruption in the relationship of two bones forming a joint, ie, a partial dislocation. The joint surfaces retain partial contact.

Subungual hematoma — A collection of blood under the nail.

Superior radioulnar joint — A uniaxial, diarthrodial joint that functions with the inferior radioulnar joint to produce rotation of the forearm or supination and pronation.

Syncope — A fainting spell or a transient loss of consciousness.

Syndesmosis sprain — A more disabling sprain compared with a lateral ankle sprain; examination will most likely reveal a positive squeeze test, a positive external rotation stress test, and point tenderness.

Synovial fluid — A fluid that has a very low coefficient of friction and provides lubrication and nutrients for joint chondrocytes.

Synovial fluid — The straw-colored fluid in the joint that is formed by filtration of capillary plasma

Synovial joints — A joint formed by the articulation of two bones, the ends of which are lined with hyaline cartilage and is surrounded by a capsule which is lined with synovium.

Synoviocytes — Cells that form the synovial membrane, remove debris, and secrete hyaluronic acid Synovitis A condition characterized by inflammation of the synovial lining

Synovium — A complex, highly permeable, and vascular tissue that lines the inner surface of joint capsules, bursae, tendons, and ligaments.

Synovium — The thin membrane that lines a joint capsule. There are two types of synovial cells. Type A act as macrophages and type B produce synovial fluid for joint lubrication. Marked hypertrophy of the synovium occurs with an inflammatory arthritis.

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Tarsal coalition — A congenital failure of segmentation between two or more tarsal bones.

Tarsal coalition — Fusion of two or more of the major tarsal bones (talus, navicular, calcaneus, and cuboid)

Tarsal tunnel syndrome — A neuritis of the posterior tibial nerve resulting in pain and/or numbness along the course of the nerve

Tendinitis — Any injury that produces an inflammatory response within the tendon substance.  Injury to the tendon or musculotendinous unit caused by the application of mechanical loads of high intensity or high frequency.

Tendinosis — An avascular degenerative process that represents the result of failed tendon healing seen with aging or following repetitive microtrauma.

Tendinosis lesion — Asymptomatic tendon degeneration caused either by aging or by cumulative microtrauma without inflammation

Tendon — A tough, rope-like cord of fibrous tissue at both the origin and insertion of muscle.  A specialized type of collagenous tissue that attaches muscle to bone. Tendons transmit forces of muscular contraction to cause motion across a joint.

Tenocytes — The cells in tendons Tenosynovitis Inflammation of the thin inner lining of a tendon sheath

Tenosynovium — The sheath surrounding a tendon that enhances movement or gliding of the tendon as it transmits muscle forces across joints

Tensile stress — One of three stresses generated in a brain injury; involves pulling or stretching of tissue.

Tension-side fractures — A stress fracture that occurs on the superior portion of the femoral neck.

Thermogenesis — The increase in energy expenditure greater than the resting metabolic rate that can be measured for several hours after a meal; also known as the thermic effect of food.

Thoracic kyphosis — Backward curvature of the cervical spine.

Thoracic outlet syndrome — Secondary compression of the brachial plexus or subclavian vessels in the thoracic outlet as the result of trauma and anatomic changes because of throwing mechanics.

Tibial stress fracture — A fracture of the lower extremity caused by repetitive loads on the bone that cause an imbalance of bone resorption over formation; often occurs after a recent increase or change in the training regimen.

Tomography — A radiographic modality that allows visualization of lesions or tissues that are obscured by overlying structures. Structures in front of and behind the level of tissue to be studied are blurred, which allows the object to be studied to be brought into sharp focus. Tomography has been used to evaluate the degree of fracture healing and to evaluate tumors such as osteoid osteoma. Increasingly, CT has replaced tomography as the imaging modality of choice in these circumstances.

Torus (buckle) fracture — A pediatric fracture that occurs at the diaphyseal-metaphyseal junction when the diaphyseal cortex is driven into the metaphysis.

Traction — Action of drawing or pullng on an object

Transcutaneous electric nerve stimulation (TENS) — A therapeutic modality that uses electrical stimulation to modulate pain, strengthen muscles, and enhance soft-tissue healing.

Transverse fracture — A fracture in which the fracture line is perpendicular to the shaft of the bone

Transverse plane — Horizontal section of the body

Traumatic brain injury (TBI) — An injury to the brain that is classified as focal or diffuse depending on the nature and severity of the injury.

Traumatic spondylolysis — The condition in which one vertebra slips anterior to the one below it secondary to a trauma-induced defect in the right and left pars interarticularis

Trochlea — A groove in a bone that articulates with another bone, or serves as a channel for a tendon to track in.

Trochlear groove — A central depression in the trochlea, a convex-shaped distal segment of the humerus.

Trochlear notch — The concave-shaped proximal segment of the ulna.

Tuberosity — Prominence on a bone where tendons insert

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Ultrasound (Ultrasonography) — An imaging modality in which images are created from high-frequency sound waves (7.5 to 10 MHz [1 MHz = one million cycles per second]) that reflect off of different tissues. The reflected sound waves are recorded and processed by a computer and then converted into an image. Ultrasound is used to evaluate infant hip disorders and tears of the rotator cuff.

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Valgus — Angulation of a distal bone away from the midline in relation to its proximal partner. Genu valgum is a knock-knee deformity, with abduction of the tibia in relation to the femur. Can also be used to describe angulation of fractures or bony deformities.

Varus — Angulation of a distal bone toward the midline in relation to its proximal partner. Genu varum is a bowleg deformity, with adduction of the tibia in relation to the femur. Can also be used to describe angulation of fractures or bony deformities.

Vertebral arch — Part of the vertebra composed of the right and left pedicles and the right and left laminae; also called neural arch

Vertebral column — Segmented spinal column composed of 24 movable vertebrae, 5 fixed sacral vertebrae, and 4 fixed coccygeal vertebrae

Vesicle — A clear fluid-filled blister that is less than 1 cm.

Viscoelastic — Having mechanical properties that depend on the loading rate of an applied force

Viscosupplements — Intra-articular hyaluronic acid preparations commonly used to treat osteoarthritis; thought to increase joint lubrication

Volar — Toward the anterior surface of the body.

Voluntary (skeletal) muscle — Muscle, under direct voluntary control of the brain, which can be contracted or relaxed at willl

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