HomeAll injuriesKnowing your Periostitis from your Tenosynovitis

Knowing your Periostitis from your Tenosynovitis

Periostitis

Pathology names such as Tibial Periostitis are made up of elements that specify the structure involved and the pathology.

In the example of Tibial Periostitis, “Tibial” refers to the bone involved (the Tibia), “Peri-” means surrounding, “-ost-” refers to bone and “-itis” indicates an inflammatory pathology.

So we know this is referring to an inflammatory pathology affecting the surrounding of the Tibial bone.

Meaning of prefixes and suffixes

Here are the most common pathology prefixes and suffixes in sports injury along with their meaning.

  • Osteo- refers to bone
  • Chondro- this refers to cartilage. Also can appear as “chondral”
  • Tendin- refers to tendon
  • Myo- this refers to muscle
  • -itis indicates an inflammatory condition, although it’s with noting that many older diagnostic terminology incorrectly used this suffix for non-inflammatory conditions (eg. Plantarfasciitis)
  • -osis refers to non-inflammatory conditions
  • -opathy is a broad term referring to “a pathology of”, for example “tendinopathy”

Examples of common pathology names

Synovitis

Inflammation of the membrane that lines various structures, known as synovium.

  • Synovium is found on the inside of joint capsules (wall of connective tissue that surrounds a joint) and in tendon sheaths (guide tubes for tendons to slide through)
  • The synovium is very sensitive and will inflame if it is overstretched, like when you roll an ankle, or compressed, such as in ankle impingement
  • It responds well to anti-inflammatory meds and ice packs
  • The most common examples of synovitis include ankle impingement and carpal tunnel syndrome (when the median nerve in the wrist is compressed by synovitis reactions in the adjacent tendons)

Periostitis

An inflammatory reaction of the periosteum which lines the outside of a bone.

  • The periosteum is a sensitive lining that covers bones. It has muscles/tendons and other connective tissues attached to it.
  • Periostitis is the symptom producing reaction for conditions such as bone stress injuries and shin splints.
  • It responds best to controlling the abnormal load causing the reaction. This is often jerky or shock loading caused by a lack of joint stability on initial loading (such as landing from a jump).
  • Although anti inflammatory medication will reduce or remove the symptoms, it does nothing time resolve the pathology and often makes it worse by masking the pain.
  • The most common periostitis condition is Tibial Periostitis (aka. Shin splints).

Enthesopathy

This is a non-inflammatory reaction of the connection interface between tendon and bone.

  • The enthesis is a narrow fibrous or fibrocartilaginous junction between a ligament or tendon and the bone
  • The cause of most enthesopathies is a sustained period of abnormal loading involving jerky or unexpected shock loading
  • It responds best to controlled loading and gradual strength training
  • Anti inflammatory meds may subdue the symptoms but they do not assist in treating the condition, often making it worse by masking the pain

Bursitis

An inflammatory reaction around the bursa (pad).

  • A bursa is a small fluid-filled sac that protects tendons from rubbing on bone
  • It responds best to reducing the load on the area by modifying activity or improving muscular control
  • It may be helped by ice packs, depending on how close the affected bursa is to the surface
  • Anti inflammatory meds are less effective due to the poor blood supply to the bursa
  • Common examples include Trochanteric Bursitis (hip bursitis) and Subacromial Bursitis (shoulder bursitis)