Clinical Examination Dictionary

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abduction: Movement away from the median plane. Opposite of adduction.
abrasion:An area of body surface denuded of skin by some mechanical process.
acetabulum:Cup shaped cavity on the outer surface of the hip bone, in which the head of the femur fits.
acromion:The acromial process, the outer and lateral extension of the spine of the scapula.
acupuncture: The ancient Chinese practice of inserting needles into specific skin sites for therapeutic purposes, eg. relief of pain and induction of anesthesia.
acute: Having a short and sharp course, not chronic.
Adam's sign: A helpful sign in differentiating functional and structural curves of the spine. Functional curves of the spine diminish during flexion while structural curves do not. When a patient with structural scoliosis bends over, he will have no straightening of the lumbar curve, hence a +ve Adam's sign.
adduction: Movement towards the median plane. Opposite of abduction.
adjustment: Skilled method of chiropractic manipulation by hand.
Adson's test: This test is performed in patients with suspected thoracic outlet syndrome. With the patient in the sitting position, his hands resting on his thighs, the examiner palpates both radial pulses as the patient rapidly fills his lungs by deep inspiration and, holding his breath, hyperextends his neck and turns his head toward the affected side. If the radial pulse on the affected side is obliterated, the test is considered positive. The latter indicates possible neurovascular compression at the supraclavicular portion of the thoracic outlet secondary to a cervical rib; dysplastic first rib; etc.
Allen's maneuver : This maneuver is useful in determining vascular patency below the wrist. The patient is asked to make a tight fist. The examiner compresses on either the radial or ulnar artery. If upon opening the fist, prolonged blanching of the palm and the fingers, (> 6 seconds), with slow return of color is noted, a partial/total occlusion is indicated in the artery that has not been compressed.
Allis's sign: See Galeazzi sign.
Amoss's sign: In painful flexure of the spine, when rising to a sitting posture from lying in bed, the patient does so by supporting himself with his hands placed far behind him in the bed.
amputation: The removal or cutting off of a limb or other appendages of the body.
anesthesia: Partial or complete loss of feeling or sensation. Can be induced pharmacologically in order to perform surgery, or can be a result of neurological disease.
ankylosis: Stiffening or immobilization of a joint due to disease, injury, or surgical procedure.
anomaly:Marked deviation from the normal standard, especially as a result of congenital defects.antalgic gait:A limp adopted as to avoid pain on weight-bearing structures, characterized by a very short stance phase.
anterior tibial sign:Involuntary contraction of the tibialis anterior muscle of the leg when the thigh is forcibly flexed on the abdomen; seen in spastic paraplegia.
anulus fibrosus:The fibrocartilage ring which surrounds the nucleus of an IV disc. Also see intervertebral disc.
Apley's test : A chiropractic test performed in patients with a suspected meniscal tear. The patient is placed prone on the examining table and the knee is flexed 90. While compressing the knee, the lower leg is rotated in both directions. A positive test produces pain, indicating a possible meniscal tear.
articulations:A loose joining or connection such that motion is allowed between parts.
arthritis: Inflammation of the joints.
arthrodesis: Artificial ankylosis.
arthrosis:Degeneration at a joint secondary to a pathological process. arthrogram:X-ray of a joint after introduction of an opaque contrast material into it.
arthropathy: Any disease affecting a joint.
arthroplasty: Creation of an artificial joint. Surgical reconstruction of a joint to achieve integrity and function.
arthroscope:An endoscope for examining the interior of a joint and for carrying out diagnostic and therapeutic procedures within a joint.
arthroscopy:Examination of the interior of a joint with an arthroscope.
ataxia: Failure of muscular coordination; irregularity of muscular action. Loss of balance.
athetosis: A neurological derangement marked by ceaseless occurence of slow involuntary movements especially severe in the hands. It may occur after hemiplegia and is then known as posthemiplegic chorea. Also called mobile spasm.
atlanto-occipital: Pertaining to the occiput and the atlas.
atlanto-odontiod:Pertaining to the atlas and the odontoid process of the axis.
atlas: The first cervical vertebra which articulates above with the occipital bone and below with the axis.
atlanto-axial: Pertaining to the atlas and the axis.
atrophy: A wasting away. Diminution in the size of a cell, tissue, orgran, or part.
aura: A subjective sensation or a motor phenomenon that precedes and marks the onset of a paroxysmal attack, such as an epileptic attack or migraine headaches.
avulsion: Tearing away of a part.
axial loading test: 1. This maneuver is performed in patients with neck/back pain. While the patient is sitting , the examiner presses down upon the top of the patient's head. A +ve test indicates pressure upon a nerve secondary to narrowing of the neural foramina, pressure on the facet joints, or muscle spasm. 2. One of the so called Waddel signs in which direct percussion of the top of the head of a standing patient produces lumbar back pain (see Waddel signs). A positive test indicates pain of non-anatomical, non-organic, non-mechanical back pain.
axis: The second cervical vertebra.
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Babinski's reflex: This reflex is performed in patients with suspected spinal cord lesions . When an examiner strokes the sole of the relaxed foot, the great toe is plantar flexed. If the toe dorsiflexes and the other toes spread out, the reflex is positive, signifying damage to the corticospinal tract, as in patients with hemiplegia.
Babinski's sign: This sign differentiates patients with genuine sciatica from those with hysteric sciatica. In true sciatica, DTR testing of the ankle produces loss or lessening of the Achilles tendon reflex, hence, a positive test.
Bakody test:A chiropractic test performed in patients with cervical pain.
Ballotment test:A palpation maneuver performed to test for a floating object. Knee ballotment refers to palpating/tapping the patella to test for the presence of effusion in the knee or retro-patellar pain.
Bekhterew's test: A chiropractic test performed in patients with low back pain. While seated, the patient is asked to extend both legs. Patients with sciatica cannot extend or stretch out both legs; but can extend each leg in turn.
belt test: See Supported Adam's test.
Bonnet's sign: Patients with lower back pain and sciatica will experience potentiation of leg pain radiation during a straight leg raising test (SLR) with adduction of the thigh, demonstrating a positive sign.
brace:An orthopaedic appliance used to support, align or hold parts of the body in correct position.
Braggard's test: A chiropractic test performed in patients with lower back pain. With the knee extended, the lower extremity is flexed at the hip just below pain production. The foot is then dorsiflexed. A positive test produces increase of radicular back pain pointing to a nerve root cause, such as sciatica, disc lesions, and cord tumors (see Laseque sign, SLR sign).
Bryant's sign: Lowering of the axillary folds in dislocation of the shoulder.
bunion:Abnormal swelling of the inner aspect of the first metatarsal head of the foot, often associated with lateral displacement of the great toe.
bursa: A closed, fluid-filled sac found in areas where friction would otherwise develop. e.g. Acromial subdeltoid bursa of the shoulder.
bursitis: Inflammation of a bursa, occasionally accompanied by a calcific deposit e.g. Acromial subdeltoid bursitis, a most common site.
C ______________________________________________________________________________C-curve:The normal cervical lordotic curvature.
calcaneus:Referred to as the heel bone. The irregular quardrangular bone at the back of the tarsal bone of the foot.
carpal tunnel syndrome: A complex of symptoms resulting from compression of the median nerve in the carpal tunnel of the wrist. Associated with pain, burning, or tingling in the fingers and the hand.
carpus: The wrist, the joint between the forearm and the hand, consisting of eight bones.
cast:A rigid dressing, molded to the body while pliable, and designed to provide support or immobilization.
CAT Scan:Computerized Axial Tomogarphy, also referred to as CT Scan.
causalgia: A burning pain often accompanied by trophic skin changes due to injury of a peripheral nerve.
cellulitis: An acute, spreading, and edematous inflammation of the deep subcutaneous tissues. Usually infectious in origin.
cervical compression test: A chiropractic test useful in identifying cervical lesions. The examiner produces compression of various cervical components with head rotation, lateral bending, extension, and flexion. The test is provocative of local cervical pain as in facet disease of the spine. It is also specific for cervical radicular causes when peripheral manifestations such as arm pain is produced.
cervical distraction test: A chiropractic test performed in patients with neck pain. Manual tractioning of the cervical spine is performed. If there is relief of neck pain or cervical radicular symptoms, a cervical facetal lesion is suspected. The test also demonstrates the beneficial effect that might be anticipated from a course of traction therapy.
cervicodynia: Neck pain.
Charcot's arthropathy: See neuropathic arthropathy.
chest expansion test: The normal difference between chest measurements of maximum inspiration and maximum expiration is approximately two inches. Diminished chest expansion of less than one inch is significant. The latter is seen in musculoskeletal/arthritic diseases of the spine and the rib cage as in Ankylosing Spondylitis, and in some respriratory diseases such as Emphysema.
chondral:Pertaining to cartilage.
chondromalacia: Abnormal softening of cartilage, most frequently seen in the patella (knee cap).
chondroplasty: Reparative or reconstructive surgery of cartilage.
chorea: Irregular, spastic, and involuntary movement of the limbs or of specific muscles.
choreoathetosis: A condition marked by choreic and athetoid (see athetosis) movements.
chronic: Persisting over a long period of time. Relates to a long-lasting disease of slow progression.
clavicle:The bone articulating with the sternum and the scapula. The collar bone.
clonus: Alternate muscular contraction and relaxation in rapid succession. e.g.;: In diseases of the spinal cord, sudden dorsiflexion of the foot may induce ankle clonus, a series of abnomal reflex movements of the foot, indicative of pressure upon the spinal cord.
coccyx: The bone forming the caudal extremity of the vertebral column, the vestige of the tail-bone.
Codman's sign: This sign is indicative of rotator cuff tear. The patient's arm is passively abducted with support by the examiner and then released at 90. The patient with a rotator cuff tear, eg: with rupture of the supraspinatus/infraspinatous tendon, will be able to abduct his arm passivley without pain but will develop pain when the support of the arm is removed and the Deltoid muscle contracts suddenly. Also see Drop arm test.
Cogwheel Phenomena: An irregular, jerky-type motion. When a hypertonic muscle is passively stretched, it resists, and this resistance sometimes takes the form of an irregular jerkiness.
Colles' Fracture: Fracture of the lower end of the radius bone in which the lower fragment is displaced posteriorly. If the lower fragment is displaced anteriorly, it is called a Reverse Colles' fracture. Also referred to a Smith's fracture.
Comolli's sign: A sign of scapular fracture. It consists of a triangular swelling in the scapular region reproducing the shape of the body of the scapula.
contusion:A bruise. An injury without a break in the skin.
costo-chondral:Pertaining to a rib at its junction with its cartilage.
costoclavicular maneuver: A chiropractic maneuver performed in patients with suspected costoclavicular syndrome. The patient is asked to brace his shoulders downward and backward while the radial pulse is monitored. Dampening or obliteration of the radial pulse is considered suggestive of costoclavicular syndrome.
costo-vertebral:Pertaining to the articulation between a rib and a vertebra.
Cozen's Test See "Tennis Elbow" test.
crepitus: The crackling, heard or palpated during a range of motion of a joint, produced by the rubbing together of the fragments of fractured bone or rough articular cartilagenous surfaces.
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Dawbarn's sign: This is a common but non-specific sign seen in patients with rotator cuff tear syndrome. In acute subacromial bursitis, when the arm hangs by the side, palpation over the bursa causes pain; the pain disappears when the arm is abducted.
debridement:Removal of devitalized tissue from or adjacent to a traumatic lesion until surrounding healthy tissue is exposed.
deformity:A partial or general disfigurement of a body part.
degenerative arthritis: See osteoarthritis.
degenerative joint disease: see osteoarthritis.Dejerine's sign: In patients with intra-thecal lesions such as spinal cord tumors and disc herniations, coughing, sneezing, and straining at stool aggravate radicular symptoms due to increased intraspinal pressure of the cerebral spinal fluid.
Demianoff's test: A chiropractic test performed in patients with lower back pain syndrome. During a straight leg-raising test, if pain occurs at or below 10, then the pain is suggestive of stretching and strain of the sacro-lumbar muscle.
Desault's sign: A sign of intracapsular fracture of the femur. Normally, the arc described by rotation of the greater trochanter of the femur describes the segment of a circle, but in this fracture it rotates only as the apex of the femur as it rotates about its own axis.
disc:A pad of fibro-cartilage found in articular joints, e.g. intervertebral disc found in between the vertebral bones. See intervertebral disc.
discectomy: Excision of part or all of an intervertebral disc.
discogenic: Caused by derangement of an intervertebral disc.
discopathy: Disease of an intervertebral disc.
dislocation: Displacement of any part out of it's normal position, especially of a bone. Also called luxation.
dorsalgia: Back pain
dorsiflexion: Upward movement of the foot or toes.
dorsum: The aspect of an anatomical part or structure corresponding in position to the back.
double straight leg raising test: This test is performed in patients with lower back pain. With the patient supine, both legs are raised together, the knees extended. Since lumbosacral movement occurs before sacro-iliac joint movement occurs, pain elicited at a lesser angle when the legs are raised simultaneously, compared to unilateral elevation, suggests lumbosacral joint dysfunction.
Drawer sign, anterior:This test is performed to determine the stability of the anterior cruciate ligament of the knee (ACL). With the patient supine and the knee in 90 of flexion, the upper tibia is pulled forward. If excessive movement is found by visual and tactile evidence, then the test is indicative of ACL tear.
Drawer sign, posterior: This test is performed to determine the stability of the posterior cruciate ligament of the knee (PCL). The patient is positioned similarly as in the anterior drawer test but tibial stressing is posterior. If excessive movement is found, then the test is indicative of a PCL tear.
Dreyer's sign: A helpful sign in diagnosing fractures of the patella. Patients with a fractured patella are usually unable to fully, actively extend the knee, but are able to do so when quadriceps muscle anchorage is provided by the examiner.
drop-arm test:This is a helpful test in diagnosis of rotator cuff tear syndrome. When a patient with subacromial bursitis or rupture of the supraspinatus tendon is asked to elevated his arm to the side and lower it slowly, he will develop pain in the deltoids and drop his arm to his side, or be unable to smoothly lower his arm. Also see Codman's Sign.
Dupuytren's sign: See Telescoping hip sign.
dynamometer:An instrument for measuring the force of muscular contraction. eg, a hand dynanometer measures the grip strength of the hand.
dysarthrosis: Deformity or malformation of a joint.
dyskinesia: Impairment of the power of voluntary muscular movement.
dyspnea: Difficult or labored breathing, shortness of breath.
dysrhythmia:A defective rhythm such as in cardiac activation or in a brain wave tracing.
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edema: Abnormal accumulation of fluid in the intercellular tissue spaces of the body with resultant soft tissue swelling.
Eden's test: This test is another version of Adson’s test performed in patients with suspected thoracic outlet syndrome. The patient is asked to take a deep breath and hold it while bracing his shoulders backwards. The radial pulse is monitored during the maneuver. A positive test produces dampening of the radial pulse, duplication of the patient's arm pain, or paresthesia suggesting neurovascular compression at the supraclavicular portion of the thoracic outlet at the first rib/clavicle interval. Also see Adson’s test.
effusion: Escape of fluid into a cavity, bursa, or joint space. Most commonly refers to increased joint fluid.
Ely's test : See Femoral Nerve Stretch Test
enthesopathy: Disorder of the muscular or tendinous attachment to bone.
enthesitis: Inflammation of the muscular or tendinous attachment to bone.
entrapment neuropathy:When a peripheral nerve is injured in its course through an osseous or fibrous tunnel, sensory/motor symptoms may occur. eg: carpal tunnel syndrome of the hand and tarsal tunnel syndrome of the foot.
Erichsen's test: See Iliac compression test
eversion: A turning outward, as of the foot.
exacerbation:Aggravation of symptoms or an increase in severity of a condition.
exostosis: A benign bony growth projecting from the surface of a bone.
extension: The movement by which two components of a joint are drawn away from each other. Opposite of flexion.
extensor: A general term for any muscle that extends a joint.
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Fabere's sign: This sign is commonly seen in patients with arthritic diseases of the hip. The name is derived from the initial letters of movements that are necessary to elicit the Patrick's test, namely flexion, abduction, external rotation, and extension. Also see Patrick's test.
facet: A small smooth surface on a bone at the site where it articulates with another bone. e.g: the articular facets of the vertebral joints.
Fairbanks test: See patella apprehension test.
Fajersztajn's crossed sciatic sign: A chiropractic sign seen in patients with ruptured intervertebral discs. In patients with sciatica, flexion of the hip with the knee held straight on the affected side elicits back pain. Furthermore, flexing the unaffected leg with the knee held straight also causes pain on the affected side, hence a positive sign. See also Well-leg-raising test, Lasegue's Contralateral sign.
Fajersztajn's test:See Braggards test, Lasegue's test, Straight leg raising test.
fascia: A sheet or band of fibrous tissue deep to the skin. Encloses muscles and muscle groups, separating them into layers.
fasciculation: Involuntary twitchings or contraction of groups of muscle fibers visible through the skin.
fasciitis: Inflammation of fascia.
femoral nerve stretch test
Also referred to as Ely's test. This test is helpful in assesing L3-L4 radiculopathy. With the patient in the prone position, the knee is fully flexed touching the heel to the buttock. A positive test produces pain in the anterior thigh upon stretching of the femoral nerve.
fibroplasia: The formation of fibrous tissue as occurs normally in the healing of wounds, and abnormally in some tissues.
fibrosis: The formation of fibrous tissue.
fibrositis: Inflammation of the white fibrous tissue of the body, especially of the muscle sheaths and fascial layers of the locomotor system. It is marked by pain and stiffness. Also called fibrofascitis and muscular rheumatism.
Finkelstein's test: This is a helpful test in diagnosing tunnel tenosynovitis. With the thumb inside the palm, the wrist and the hand are ulnarly deviated. A positive test produces pain at the radial side of the wrist and thumb indicating stenosing tendonitis of the extensor/abductor tendons of the thumb, commonly referred to as DeQuervain's syndrome.
flap:A mass of tissue used for grafting usually including skin and its blood supply.
flexion: The act of bending. Opposite of extension.
flexor: Any muscle that flexes a joint.
flip sign: In patients with true sciatica, both sitting and supine straight leg raising tests are expected to be positive, producing radicular pain. If only one test is positive, there may be a suggestion of functional overlay. Also see Waddell's sign.
fossa: A general term for a hollow or depressed area. e.g: acetabullar fossa of the hip, popliteal fossa of the back of the knee.
foramen: A general term for a natural opening or passage, especially one into or through a bone. e.g: the vertebral foramen.
foraminotomy:The operation of widening of interverebral foramina, done for the relief of nerve root compression.
Fouchet sign:
See patellar grinding test.
fracture: A break in a bone.
Frankel's sign: Excessive range of passive movement of the hip joint, indicating diminished tone of the surrounding musculature as seen in tabes dorsalis of syphilis.
Froment's paper sign: A patient with ulnar neuropathy who has paralysis of the adductor pollices muscle, when asked to hold a sheet of paper between his thumb and index finger, will do so by flexing the distal phalynx of the thumb instead of adducting it.
functional: Affecting the function but not the structure.
fusion: The operative formation of ankylosis or arthrodesis of a joint.
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Gaenslen's test: A chiropractic test performed in patients with suspected sacro-iliac joint disease. The test is carried out with the patient lying on his/her back. The knee and hip of one leg are held in flexed position by the patient while the other leg is unsupported and allowed to extend toward the floor, hyperextending the hip. A positive test produces pain in the hip on the affected side suggesting sacro-iliac pathology.
Galeazzi sign: This sign signifies dislocation of the hip. With the patient lying supine, the knee and hip flexed, and the feet flat, the difference of the knee levels is observed. The knee on the side of the dislocated hip usually recedes behind the other side secondary to shortening of the femur. Also referred to as Alli's sign.
genu: The knee.
genu valgum: Knock knee deformity marked by abduction of the leg in relation to the thigh.
genu varum: Bowleg deformity – an outward bowing of the legs.
Gillis test:The test is helpful in determining presence of bicipital tendonitis. With the patient's elbow flexed and stabilized, the examiner externally rotates and pulls down on the patient's arm. A positive test produces pain (Supination sign) in the arm in cases of bicipital tendonitis. The test is also helpful in determining the stability of the biceps tendon in the bicipital groove. Also referred to as Yergason's Test.
Goldthwait's test: A chiropractic test performed in patients with lower back pain. With the patient in the supine position, SLR is performed while the examiner's hand is under the patient's lower back palpating the lumbar lordosis. If pain is elicited before the lumbar spine moves (0-30), a sacroiliac sprain is favored. If pain is noted after the lumbar spine moves (30-60), a lumbosacral sprain is favored.
goniometer: An instrument for measuring angles of range of motion.
GonsteadA chiropractic system of analyzing x-rays for subluxations, and a techinque of manual adjustment for correcting these subluxations.
gout: A disease characturized by inflammatory arthritis and tophi induced by uric acid crystal deposition.
gouty arthritis: Arthritis associated with gout, also called uratic arthritis.
graft: Any tissue or organ for implantation or transplantation.
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Harrington procedure:The surgical implantation of a rod in the posterior elements of the spine to provide distraction and compression in treatment of scoliosis and other spine deformities.
Hart's sign: In congenital dislocation of the hip, as both hips are flexed to a right angle, abduction is limited on the affected side, and the adductor muscles are tight and contracted.
hematoma:A localized collection of blood, usually clotted, in an organ, a space, or a tissue.
hemiplegia: Paralysis of one side of the body.
herniated intervertebral disc:Protrusion of part of an interverebral disc which may impinge on spinal nerve roots.
Hibb's test: A chiropractic test helpful in determining sacroiliac joint pathology. The patient lies prone and the examiner flexes the leg on the thigh and extends the leg with internal rotation of the hip joint. A positive test produces pain in sacroiliac joint diseases.
Homan's sign: A sign of deep vein thrombophlebitis. Patients with thrombosis of deep calf veins will have pain behind the knee on dorsiflexion of the ankle.
Hoover's sign: A helpful sign in differerentiating patients with genuine lower back pain from those with non-organic pain. In the normal state or in genuine paralysis, with the patient in the supine position, elevation of one leg causes a lifting movement in the other leg with pressuring downward. This phenomenon is absent in hysteric and malingering patients.
Howship-Romberg sign: In patients with an obturator hernia, pain is felt down the inner side of the thigh to the knee due to pressure on the obturator nerve.
hunchback: A rounded deformity of the back. See kyphosis.
hyperalgesia: Extreme sensitivity to pain.
hyperesthesia: Abnormally increased sensitivity to stimuli.
hypermyotonia: Excess of muscular tonicity.
hyperostosis: Hypertrophy of bone.
hyperpyrexia:Highly elevated body temperature.
hypertrophy:General increase in size of a part or organ, not a result of tumor formation.
hypoalgesia:Diminished sensitivity to pain.
hypoesthesia: Abnormally decreased sensitivity.
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iliac compression test: With the patient lying on his side, the examiner presses the iliac crests toward each other. A positive test produces pain over the sacroiliac joint, indicating intra-articular sacroiliac pathology. Also referred to as Erichsen's Test:
implant:To insert or graft a tissue or a material into the body of a recipient.
impingement sign: This sign is frequently seen in patients with rotator cuff syndrome. The shoulder is abducted or adducted and internally rotated causing the greater tuberosity of the humerous to press against the undersurface of the acromion. A positive test produces pain in the shoulder indicating an inflammatory lesion of the rotator cuff ( e.g. tendonitis). It is most painful at 90 of abduction.
inclinometer:An instrument used for determining ranges of motion and visual inclinations.
intervertebral: Situated between two contiguous vertebrae.
intervertebral disc: Layers of fibrocartilage between the bodies of two adjecent vertebrae consisting of a fibrocartilage ring peripherally (annulus fibrosis) and a pulpate center (nucleus pulposus).
intervertebral foramen: The passage formed by the inferior and superior notches on the pedicles of adjacent vertebrae; it transmits a spinal nerve and vessels.
intra-articular: Within a joint.
inversion: Turning inward as of the foot. Opposite of eversion.
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Jackson compression test:
A chiropractic test performed in patients with neck pain, useful in determining cervical lesions. With the patient's head rotated alternatively to each side, the examiner applies axial loading force to the vertex. A positive test produces local pain in facetal disorders and peripheral pain may be reproduced with a nerve root lesion.. Also see Axial loading test and Cervical compression test.
Jansen's test:
In patients with osteoarthritis of the hip, crossing the legs at a point just above the ankle is very difficult to accomplish.
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Ober's test: With a patient on his side (good side down) the affected hip is flexed 90 , and then adducted. The hip is then abducted and extended. Failure to obtain full abduction or pain over the trochanteric area indicates tightness of the fascia lata or ilio-tibial band.
objective: Perceived and visualized by the examining physician.
olecranon: The proximal bony projection of the ulna at the elbow joint.
orthopaedics: Branch of surgery concerned with the preservastion and function of the musculo-skeletal system, locomotion, and its articulations and associated structures.
os: Meaning bone.
osteoarthritis: Degenerative joint disease occurring chiefly in older persons. It is characterized by degeneration of the articular cartilage, hypertrophy of bone at the margins, and changes in the synovial membrane. It is accompanied by pain and stiffness, particularly after prolonged activity. Also called degenerative arthritis, hypertrophic arthritis, and degenerative joint disease.
osteochondritis: Inflammation of both bone and cartilage.
osteochondroma: Osteoma blended with chondroma, a benign tumor consisting of projecting adult bone capped by cartilage. Also called chondrosteoma.
osteochondrosis: A disease of the growth or ossification centers in children which begins as a degeneration or necrosis followed by degeneration or recalicification. Also called epiphyseal ischemic necrosis.
osteodynia: Pain in bone.
osteoma: A tumor composed of bone tissue.
osteomalacia: A condition marked by softening of the bones due to impaired mineralization, with excess accumulation of osteoid with pain, tenderness, muscular weakness, anorexia, and loss of weight, resulting from deficiency of vitamin D and calcium.
osteomyelitis: Inflammation of a bone caused by an infection.
osteopathy: Any disease of a bone.
osteopenia: Reduced bone mass due to decrease of bone synthesis.
osteophyte: An excessive bony or osseous outgrowth as seen in degenerative diseases of the spine.
osteoporosis: Reduction in the amount of bone mass leading to fractures after minimal trauma, most commonly seen in the elderly.
osteotomy: Surgical cutting of a bone.
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palpation: The act of feeling with the hand. Application of light pressure to the surface of the body for the purpose of determining the consistence of the parts beneath in a physical diagnosis.
palsy: Paralysis para: A prefix meaning meaning beside or near.
paralysis: Loss or impairment of motor function.
paraplegia: Paralysis of the lower extremities.
paraspinal: Beside the spine.
paresis: Slight or incomplete paralysis.
paresthesia: Abnormal sensation, such as burning, prickling, tingling, or tickling.
patella: Knee cap.
patellar apprehension test:With the patient supine and the knee slightly flexed, the examiner attempts to push the patella laterally. Patients who have experienced either dislocation or subluxation of the patella will become apprehensive, and attempt to stop the examiner.
patellar grinding test:This test is performed in patients with suspected chondromalacia. The examiner palpates the knee during the flexion/extension range of motions. A positive test produces grinding/crepitus (positive Fouchet sign) with this maneuver. Also see quadriceps inhibition test.
pathognomonic: Specifically distinctive or characteristic of a disease or pathological condition; a sign or symptom on which a diagnosis can be made.
Patrick's test: A clinical test for determining hip pathology. The patient lies supine and the foot of the involved side is placed over the knee of the opposite side. The hip is flexed, abducted, externally rotated, and extended, placing the anterior capsule under stress. A positive test produces pain in the hip (Fabere sign) indicating arthritis of the hip.
pedal: Pertaining to the foot.
Phalen's maneuver: This test is used to reproduce the symptoms of carpal tunnel syndrome. The wrist is fully flexed or extended for 30-60 seconds. A positive test reproduces median nerve compression symptoms of pain and parathesia in the lateral three fingers. Also see Median nerve compression test, Tinel's test.
phlebitis: Inflammation of a vein.
pivot-shift test:See MacIntosh Test:
plate: A flat structure or layer such as a thin layer of bone, a lamina-layer.
prognosis: Prospective outcome of a condition or disease.
pronation: The act of assuming the prone position as in turning the forearm so that the palm of the hand faces backwards.
prosthesis: An artificial substitute for a missing body part.
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quadriceps inhibition test: Pressure is placed over the superior aspect of the patella. The patient is asked to perform a SLR maneuver. A positive test produces pain and grinding in the knee, indicating chondromalacia of the patella.
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radial: Pertaining to the radial bone/nerve/artery.
radical: Any one of the smallest branches of a vessel or a nerve.
radicular: Of or pertaining to a radical or root.
radiculitis: Inflammation of the root of a spinal nerve, especially of that portion of the root which lies between the spinal cord and the intervertebral canal/foramen.
radiculopathy: Disease of the nerve roots.
radiograph: : A film of internal opaque or semi translucent structures of the body produced by the passage of x-rays or gamma rays on a specialized sensitized film; a radiogram.
radius: The lateral and shorter of the two forearm bones.
reduction: Repositioning of a part to its normal anatomical place/relation.
rehabilitation: The restoration of an ill or injured patient to self sufficiency or to gainful employement.
residual: Remaining or left behind.
rheumatism: Any or a variety of disorders marked by inflammation, degeneration, or metabolic derangement of the connective tissue structures of the body, especially the joints and related structure, including muscles, bursae, tendons and fibrous tissue. It is attended by pain, stiffness, or limitation of motion of the parts. Rheumatism confined to the joints is classified as arthritis. rheumatoid arthritis: A chronic systemic disease primarily of the joints marked by inflammatory changes in the synovial membranes and articular structures, and by atrophy and rarefaction of the bones. In late stages deformity and ankylosis develop. The cause is unknown, but auto-immune mechanisms and virus infection have been postulated.
rotation: The process of turning around an axis.
rotator cuff syndrome: Refers to the inflammation/tear of any of the muscles/tendons/bursae involved in the rotatory action of the shoulder. eg. subacromial bursitis, supraspinatous tendon rupture, etc. Commonly seen in baseball pitchers.
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sacroiliac: Pertaining to the sacrum and iliac bones, denoting the joint.
sacroiliitis: Inflammation of the sacroiliac joint.
scar: The mark remaining after the healing of a wound.
sciatica: Lower extremity radicular pain along the distribution of the sciatic nerve in patients with lower back pain with disc herniation and nerve root compression.
sclerosis: Hardening of a part from inflammation/disease as hardening of blood vessels (arteriosclerosis) and of the nervous or skeletal systems.
scoliosis: An appreciable lateral deviation (side to side) in the normally straight vertical line of the spine.
shoulder apprehension test:The shoulder is forcefully abducted and externally rotated. Patients who have experienced either dislocation or subluxation of the shoulder will become extremely apprehensive with this maneuver. This maneuver may suggest a recurrent dislocation of the shoulder.
shoulder depression test: A chiropractic test performed in patients with neck pain. With the patient seated, the examiner depresses the shoulder while laterally flexing the head to the opposite side. A +ve test produces/aggravates radicular pain suggesting local capsular or dural root adhesions.
Sicard sign: In full blown intervertebral disc, big toe dorsi flexion induces sciatic pain.
Soto-Hall sign: A chiropractic test performed in patients with neck pain. With the patient flat on his back, the examiner flexes the spine, beginning at the neck and proceeding downward. A positive test produces pain of the interspinous ligaments at the level of the neck lesions.
spasm: A sudden, violent, involuntary temporary contraction of a muscle or a group of muscles. Can be attended by pain and interference with function, producing involuntary movement and distortion.
splint: A rigid or flexible appliance used to maintain a displaced or movable part in the resting position or to support/brace a painful part.
spondy: A prefix, pertaining to the spine.
spondylarthritis: Arthritis of the spine.
spondylitis: Inflammation of a vertebra(e).
spondylolisthesis: Forward displacement of one vertebra over another, usually of the fifth lumbar over the body of the sacrum, or the fourth lumar over the fifth.
spondylolysis: A defect in the interarticular part of a vertebra.
spondylosis: Anklyosis of a vertebral joint. Also a general term for degenerative changes in the spine.
sprain: A joint injury in which some of the fibers of the supporting ligament are ruptured, but continuity of the ligament remains intact. Graded as I (mild), II (moderate), or III (severe).
Spurling's Test: See Cervical compression test.
stoop test: Patients with spinal stenosis who develop lower back and leg discomfort after walking briskly for one minute are frequently relieved by stooping for just a few moments. Symptoms may be provoked by extension.
straight leg raising test: An important clinical test performed in patients with lower back pain. This test is performed while the patient is supine or seated. With the knee extended, the leg is raised, flexing the hip. A positive test results in pain in the sciatic nerve distribution, and suggests a disc herniation.
strain: An overstretching or overexertion of some part of the musculature or ligaments. Graded as I (mild), II (moderate), or III (severe).
Strunsky's sign: A sign for detecting lesions of the anterior arch of the foot. The examiner grasps the toes and flexes them suddenly. This procedure is painless in the normal foot, but causes pain if there is inflammation of the anterior arch.
subjective: Perceived only by the affected individual, not perceptable to the senses of another person.
subluxation: 1. Orthopaedic: An incomplete or partial dislocation. 2. Chiropractic: Any alteration of the biomechanical and physiological dynamics of contiguous spinal and paraspinal structures.
supination: The act of assuming the supine position as in turning the forearm so that the palm of the hand faces forward.
Supination sign: See Gillis test:
supine: Lying with the face upward.
supported Adam's test: A chiropractic test performed in patients with lower back pain. The patient is supported by the examiner during forward bending. If the patient’s pain remains the same, a lumbosacral lesion is implied; if the patient's pain lessens, a sacroiliac problem is suspected; and if the patient’s pain is worsened, a disc lesion is suggested. Also called Belt Test.
supraspinatus isolation test: Strength of abduction of the shoulder is tested by abducting and forward flexing the arm with the forearms in internal rotation. This maneuver isolates the supraspinatus muscle, the most common area of weakness in rotator cuff tears.
synovial fluid:A viscous, straw-colored fluid secreted by the synovial membrane and contained in joint cavities, bursae, and tendon sheets.
synovitis:Inflammation of the synovial membrane.
synovium:A synovial membrane.
Szabo's sign:Loss of sensation/parathesia along the outside edge of the foot in cases of sciatica with L4-L5 lesions.
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talus: The bone of the foot which articulates with the socket formed by the tibia and fibula to form the ankle joint.
tarsal tunnel syndrome:A complex of symptoms resulting from compression of the posterior tibial nerve in the tarsal tunnel of the foot, with pain, numbness, and tingling of the sole of the foot.
telescoping hip signThis sign is frequently seen in a newborn with congenital dislocation of the hip. It is characterized by an abnormal degree of up and down movement felt at the hip with alternating leg push-pull efforts. Also called Dupuytren's Sign.
tendinitis:Inflammation of a tendon.
tendon:A fibrous cord of connective tissue in which the fibers of a muscle end, and by which a muscle is attached to a bone.
tennis elbow test:The examiner asks the patient to extend the elbow, pronate the forearm, and flex the wrist against resistance. Inflammtion at the origin of the lateral extensor tendons of the elbow, frequently seen in tennis players, produces lateral epicondylar pain of the elbow.
tenosynovitis:Inflammation of a tendon sheath.
Thomas test: A chiropractic test used in patients with flexion contracture of the hip. The test is performed with the patient supine. With one knee flexed and touching the chest, the opposite extremity should be able to fully extend. If the opposite thigh lifts from the table, a flexion contracture is indicated. Measurement of the angle between the thigh and the table represents the degree of flexion deformity.
thoracic outlet syndrome:Compression of brachial plexus nerve trunks, characterized by pain in the arms, parathesia of the fingers, vasomotor symptoms, and weakness with wasting of the small muscles of the hand.
Tinel's sign: A clinical test performed in patients with carpal tunnel syndrome. It is performed with gentle percussion over the volar carpal ligament. A positive test elicits tingling sensations in the median nerve distribution. It indicates a partial lesion or the preliminary regeneration of cutaneous branches of the median nerve.
tinnitus: A sensation of whistling, ringing, or tingling in the ears.
torticollis: A contracted state of the cervical muscles producing twisting off the neck. Wry neck.
Trendelenburg's test: A clinical test used to determine the strength of the gluteus medius muscle. It is performed with the patient standing erect on one leg while lifting the other leg. Usually the gluteus medius muscle on the supported side contracts to elevate the pelvis on the unsupported side. A positive test produces sacral dimples when the pelvis on the unsupported side is not maintained and drops to a level below the supported side. This is commonly encountered in patients with deformity of the femoral neck, a dislocated hip joint, and weakness of the gluteus medius muscle.
Turyn's sign: In sciatica, if the examiner bends the patient’s great toe dorsally, pain will be felt in the buttocks. Also see Sicard sign.
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ulna:The inner and larger bone of the forearm on the side of the little finger.
Ulnar:Pertaing to the ulna, the medial aspect of the arm as compared to the radial (lateral) aspect
ultrasonography:Visualization of deep structures of the body by recording the reflections of pulses of ultrasonic waves directed into the tissues.
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valgus: Bent or twisted outward.
valgus stress:This test of the knee determines the integrity of the tibial medial collateral ligament. The knee is stressed into valgus (outward) at varying degrees of flexion (up to about 30); tibial rotation is avoided as the amount of medial joint space opening is judged.
valsalva maneuver: With forceable exhalation effort against a closed glottis, an increase in intrathoracic pressure interferes with the venous return to the heart. The latter increases the intrathecal cerbrospinal fluid pressure. With space-occupying lesions violating the spinal canal, the patient may develop spinal pain or peripheral radicular manifestations.
Vanzetti's sign: In sciatica, the pelvis is always level and horizontal in spite of scoliosis, but in other lesions with scoliosis, the pelvis is inclined.
varus: Bent inward, deviation toward the midline.
varus stress:This test of the knee determines the intergrity of the tibial collateral ligament. The patient is supine and the knee is stressed into varus (inward) at varying degrees of flexion (up to 30); tibial rotation is avoided, and the amount of lateral joint space opening judged.
vertebra: Any of the 33 bones of the spinal column comprising the 7 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 4 coccygeal vertebrae.
Vertical compression test: See Axial loading test, Cervical compression test:
vertigo: An illusion of movement as if the external world were revolving around the patient. Dizziness.
Villaret's Sign: In sciatica, the greater toe will flex upon tapping the Achilles tendon.
Volar:Opposite of dorsal. ie; the palmar side of the hand.
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Waddell's signs: These are a group of five physical signs originally described by Dr. Gordon Waddell in 1980 as "Non-organic Physical Signs in Low Back Pain". Patient are tested for appropriateness of response for:
1. Tenderness: superficial/deep-sacral tenderness of inappropriate location or latitude.
2. Simulation: axial loading/rotation of trunk.
3. Distraction: ROM observation/SLR-sitting and lying (flip test).
4. Regional: nonanatomic sensory/motor defict not of dermatomal distribution.
5. Overreaction with inconsistencies in affect/response.
Inappropriate response in 3/5 signs is very suggestive of functional overlay in patients with lower back problems.
Wartenberg's sign: A sign of ulnar palsy in the hand, consisting of a position of abduction assumed by the little finger.
well-leg raise test : During SLR testing of the well (unaffected) side, pain felt on the opposite (affected) side is strong presumptive evidence of a disc lesion. Also called Lasegue Contralateral Sign, Fajerztajn's Crossed Sciatic Sign.
Wright's test: A chiropractic test performed in patients with suspected thoracic outlet syndrome or hyperabduction syndrome. The test is performed with the patient seated. The examiner palpates the radial pulse and abducts the arm into an overhead and hyperabducted position. Dampening of the pulse is considered a positive sign for the 'hyperabduction syndrome'. Also see Adsons sign.
wrist flexion compression test:See Phalen's test.
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xenograft:A graft of tissue transplanted between animals of different species.
xerosis:Abnormal dryness as of the skin, eyes or mouth.
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Yeoman's hip extension test See Femoral Nerve Stretch Test :
Yergason test: See Gillis Test.
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A surgical technique to avoid flexor contractured scars on the flexor aspect of a joint by breaking it up in a zig-zag fashion and then allowing healing with clearance of contracture by the scar.