Overuse Tendon Conditions: Time to Change a Confusing Terminology
Overuse Tendon Conditions: Time to Change a Confusing Terminology
Abstract & Commentary
Synopsis: Correct and specific medical terms should be used to describe certain musculoskeletal conditions.
Source: Maffulli N, et al. Overuse tendon conditions: Time to change a confusing terminology. Arthroscopy 1998;14(8):840-843.
Maffulli and associates revisit the argument that terms such as tendonitis (a condition characterized by acute edema and hyperemia with infiltration of inflammatory cells) and tendonosis (tendon degeneration characterized by an angioblastic reaction with random orientation of blood vessels and abnormal appearance of collagen fibers without clinical or histologic signs of intra-tendinous inflammation) are histopathologic terms and should be used only when the microscopic diagnosis of the condition has been confirmed.
Maffulli et al argue that the suffix "-dynia" attached to the involved tendon’s root word should be used to describe a painful tendon. When describing the clinical syndrome characterized by pain and swelling and impaired performance, they feel the suffix "-opathy" should be used. Hence, Achillodynia refers to a painful Achilles tendon and Achilles tendinopathy is the term best used to describe the clinical syndrome of pain and swelling of the tendon associated with a decrease in performance.
Comment by Letha Y. Griffin, MD, PhDAs Maffulli et al emphasize, inaccurate use of terminology can lead to significant confusion when trying to provide patients with predictions of clinical course or when attempting to compare clinical outcomes. In the past, these same concerns have been raised over the use of the histopathologic term, chondromalcia, to describe the clinical syndrome of patella pain, making interpretation of the literature regarding this entity confusing. Therefore, the admonition expressed by Maffulli et al in their title, "Time to Change a Confusing Terminology" does seem to have merit and all of us should consider heeding their plea.
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