Michael J. Thorpy, MD
Chairperson
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Emile R. Mohler III, MD
Chairperson
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John S. Sundy, MD, PhD
Chairperson
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Glossary
Acute akathisia
A neuroleptic-induced movement disorder characterized by restlessness or inner tension, particularly in the legs, or an inability to maintain a posture for several minutes; often described as a “need for constant motion.” Onset occurs within hours or days. See also: Akathisia.
Acute low back pain
Back pain felt below the waist and caused by an injury (trauma). The pain is often described as sudden, sharp, persistent, or dull. Acute low back pain can often be treated through pain medicines and staying physically active (additionally, physical activity plays an important role in helping to prevent the condition). See also: Chronic low back pain.
Akathisia
A neuroleptic-induced movement disorder characterized by restlessness or inner tension, particularly in the legs, or an inability to maintain a posture for several minutes; often described as a "need for constant motion."
- Acute akathisia
Akathisia with an onset occuring within hours or days.
- Tardive akathisia
Implies delayed onset of akathisia (usually 3 months), not related to a recent change in drug or dose; it has been found to be significantly associated with tardive dyskinesia.
- Chronic akathisia
Refers to a persistence of symptoms for 3 months irrespective of the type of onset.
Amyotrophic Lateral Sclerosis (ALS)
ALS, or Lou Gehrig’s disease, is a motor neuron disease that attacks both upper and lower motor neurons and causes degeneration throughout the brain and spinal cord. A common first symptom is a painless weakness in a hand, foot, arm, or leg, accompanied by walking difficulty.
Ankle-brachial index (ABI)
A diagnostic test that predicts the severity of peripheral arterial disease (PAD) and is calculated by dividing the systolic blood pressure (SBP) in the ankle by the higher of the two SBPs in the arms.
Ankylosing spondylitis
A rheumatic disease that causes arthritis of the spine and sacroiliac joints; can cause inflammation of the eyes, lungs, and heart valves. It ranges from sporadic episodes of back pain occurring throughout life to a severe, chronic disease that attacks the spine, peripheral joints, and other organs, progressively resulting in severe joint and back stiffness, motion loss, and deformity.
Atherosclerosis
Narrowing of the arteries in the legs due to the accumulation of plaque. Results in a restriction of blood flow, causing leg cramps, or intermittent claudication, the hallmark symptom of peripheral arterial disease (PAD).
Central nervous system
The central nervous system refers to the brain and spinal cord, which serve as the main "processing center" for the entire nervous system, controlling the body. It does not include the peripheral nerves in the arms, legs, muscles, and organs.
Cervical spinal stenosis
Stenosis in the upper spinal cord. See also: Spinal stenosis.
Chronic akathisia
A neuroleptic-induced movement disorder characterized by restlessness or inner tension, particularly in the legs, or an inability to maintain a posture; often described as a “need for constant motion.” Chronic akathisia refers to a persistence of symptoms for 3 months irrespective of the type of onset. See also: Akathisia.
Chronic exertional compartment syndrome (CECS)
A musculoskeletal condition commonly affecting athletes and often resulting from repetitive exercise activities. The condition causes pain and abnormally increased compartment pressures in the affected extremity, which is most often the lower leg (though the thigh, foot, upper-extremity musculature, and erector spinae musculature may also be affected). While most often reported in physically active people, CECS can affect sedentary people, as well.
Chronic low back pain
Back pain felt below the waist and associated with heavy physical work, lifting or forceful movement, bending or twisting, awkward positions, or standing in one position too long. The pain is often described as sudden, sharp, persistent, or dull. Treatment can include medications such as acetaminophen, cyclo-oxygenase-2 (Cox-2) inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs), or muscle relaxants (for short-term use). Treatment also involves staying active. See also: Acute low back pain.
Claudication
Pain or fatigue in legs and arms due to a poor supply of oxygen to the muscles. See also: Intermittent claudication.
Complex regional pain syndrome (CRPS)
A chronic pain condition believed to be the result of dysfunction in the central or peripheral nervous systems. Changes can be observed in the color and temperature of the skin over the affected limb or body part, accompanied by intense burning pain, skin sensitivity, sweating, and swelling. There are two types of CRPS with similar signs and symptoms but different causes:
Complex regional pain syndrome (CRPS) Type I
Previously known as regional sympathetic dystrophy syndrome, CRPS Type I is a chronic pain condition that occurs after an illness or injury but does not directly damage the nerves in the affected limb. See also: Complex regional pain syndrome.
Complex regional pain syndrome (CRPS) Type II
Previously known as causalgia, CRPS Type II is a chronic pain condition that follows a distinct nerve injury. See also: Complex regional pain syndrome.
Contusion (bruise)
An injury resulting in a subcutaneous hemorrhage but not a break in the skin. Contusions on the legs can result in ossification (myositis ossifican) and limited range of leg motion, and may be treated with rest or compression.
Critical limb ischemia
A severe blockage of the arteries, decreasing blood flow to the hands, feet, and legs. It progresses to the point of severe pain and even skin ulcers or sores; often present in individuals with severe peripheral arterial disease (PAD). Also called “rest pain."
Cystic adventitial disease of the popliteal artery
A rare disease of the arteries characterized by intermittent claudication and synovial-like cysts within the artery wall. The condition tends to affect otherwise healthy men who do not have cardiovascular risk factors for atherosclerosis.
Deep vein thrombosis (DVT)
A manifestation of venous thromboembolism (VTE), deep vein thrombosis (DVT) is a condition in which a blood clot forms in a vein that is deep inside the body, mainly in the veins of the lower legs, thighs, or pelvis. DVT is characterized by pain, tenderness, swelling, or inflammation.
Diabetic peripheral neuropathy (DPN)
A neurologic disorder in which the peripheral nerves are damaged due to diabetes. Commonly affects the sympathetic (also called somatic or sensorimotor) nervous system, which can cause very painful and even disabling symptoms described as “pain in the bones" or "feet on fire." Symptoms, including pain, loss of sensation, and tingling, usually begin in the lower extremities and progress upward. See also: Peripheral neuropathy.
Dysesthesia
A condition in which a sense, particularly touch, is distorted. It has been described as a burning, aching, and tingling discomfort that commonly occurs in the limbs. Dysesthesia can cause an ordinary sensation to be unpleasant or painful. Commonly seen in people with diabetes.
Dyskinesia
Difficulty or distortion in performing voluntary movements, as in tic, chorea, spasm, or myoclonus; can be a side effect of certain medications such as levodopa and antipsychotics.
Dystonia
A disabling movement disorder characterized by prolonged, repetitive muscle contractions that may cause twisting or jerking movements of the body or a body part.
Edema
Swelling caused by fluid in the body's tissues; usually occurs in the feet, ankles, and legs, but it can involve the entire body. See also: Lymphedema.
Ehlers-Danlos syndrome
A group of disorders characterized by defective connective tissue; affects mostly the skin and joints. Symptoms can include joint pain, early onset of osteoarthritis, wounds that heal slowly or poorly, and joint hypermobility. Although people with this condition generally have a normal life expectancy, those with the vascular form can experience complications such as ruptured organs or blood vessels.
Exertional leg pain
A characteristic of peripheral arterial disease (PAD); caused by atherosclerotic and nonatherosclerotic arterial occlusive disease, neurogenic claudication, venous claudication, or arthritis.
Fibromyalgia
A chronic condition characterized by widespread pain in the muscles, ligaments, and tendons, as well as fatigue and multiple tender points.
Gout
Gout is a form of arthritis that usually affects one joint at a time, most often the big toe. It results from a buildup of uric acid in the body’s tissues, causing inflammation.
Hemiparesis
Partial paralysis or weakness affecting one side of the body. See also: Ipsilateral hemiparesis.
Hereditary spastic paraparesis
A hereditary disorder affecting roughly 3 out of every 100,000 people; can cause a number of symptoms in the legs. Symptoms can include leg cramps, highly arched feet (pes cavus), and weakness of some leg muscles (including those responsible for bending the knees or flexing the thighs). Those who have a parent with hereditary spastic paraparesis have a 50% chance of developing it themselves.
Hyperkinesia
Excessive or abnormally increased muscular function or activity.
Hypnic jerks
Sudden, brief jerks at sleep onset, mainly in the legs or arms. Associated with at least one of the following: person feels he/she is falling, sensory flash, or hypnagogic dream.
Hypokinesia
An abnormal decrease in motor function or activity.
Idiopathic restless legs syndrome
The most common type of RLS (also known as primary RLS); usually a lifelong condition. Symptoms tend to worsen and occur more often over time, especially if they begin in childhood or early in adult life. In milder cases, there may be long periods without symptoms, or symptoms may last for only a limited time. See also: Restless legs syndrome: Primary RLS.
Intermittent claudication
The hallmark symptom of peripheral artery disease (PAD) in which a lack of blood flow—or arterial insufficiency due to atherosclerosis—results in intermittent lower leg pain. It typically occurs with walking and relieves with rest. Intermittent claudication may occur in one or both legs and often worsens over time.
Ipsilateral hemiparesis
A condition in which a supratentorial mass lesion displaces the brain stem against the tentorium (which is a covering over the cerebellum). Also referred to as Kernohan's phenomenon.
Klippel-Trénaunay syndrome
A congenital vascular disorder causing abnormalities mostly along the lower limbs. Among these abnormalities are the “port-wine stain” (a lesion ranging in color from very light to dark maroon) and vascular abnormalities (such as atrophy or venous varicosities). Treatment may involve supportive care, laser therapy or surgery, and sclerotherapy (in which a chemical is injected into the vein responsible for the inflammation).
Laceration
An acute (traumatic) musculoskeletal injury causing a rough, mangled, jagged wound. Treatment for lacerations may involve applying sutures, skin closures, or splints while the patient is under local anesthesia.
Limb-shaking transient ischemic attack
A rare manifestation of severe carotid stenosis that can be distinguished from motor seizures by their postural character, usually occurring promptly on standing, and their association with the arms, legs, or both.
Lumbar spinal stenosis
Stenosis in the lower spinal cord. See also: Cervical spinal stenosis.
Lymphedema
A chronic swelling condition that occurs when lymphatic fluid builds up in the body’s tissues; mostly affects the arms or legs. Besides swelling, symptoms of lymphedema can include pitting, discomfort, heaviness, and loss of mobility. While the condition cannot be cured, it can generally be managed with treatments such as elevation of the limb, exercise, and compression bandages or stockings. See also: Edema.
Meralgia paresthetica
Pinching of the nerve that supplies sensation to the outer portion of the thigh, characterized by tingling, numbness, and/or burning pain; usually associated with enlargement of the belly, such as in obesity or pregnancy.
Microvenular hemangioma
Part of the class of acquired vascular tumors, microvenular hemangioma is a slow-growing, asymptomatic lesion that affects mostly the upper limbs. The tumor ranges in size from 0.5 to 2 cm, has an angiomatous appearance (meaning that it is made up of blood vessels), and is lined by a layer of endothelial cells.
Movement disorder
A neurologic condition that affects the speed, fluency, quality, and ease of movement. Abnormal fluency or speed of movement (dyskinesia) may involve excessive or involuntary movement (hyperkinesia) or slowed or absent voluntary movement (hypokinesia).
Neuroleptic-induced akathisia
A common side effect of antipsychotic medications characterized by fidgety movements and inner restlessness. These symptoms can severely annoy or even torment patients, and may persist even after neuroleptic treatment has stopped. Although it can be challenging to diagnose (the condition manifests in a number of ways), it can be treated with beta blockers, anticholinergics, and benzodiazepines, among other drugs.
Neuroma
A painful condition, also referred to as a “pinched nerve” or a nerve tumor, which is a benign growth of nerve tissue frequently found between the third and fourth toes; can cause pain, a burning sensation, tingling, or numbness between the toes and in the ball of the foot.
Nocturnal leg cramps
Pain in the leg or foot, associated with sudden muscle hardness or tightness, which typically persists for up to 10 minutes; often occur during sleep.
Osteoarthritis (OA)
A degenerative joint disease that contributes to the structural and functional failure of synovial joints; affects joints in the hands, feet, knees, hips,
and spine.
Paratenonitis
Inflammation of the paratenon, or the areolar tissue between a tendon and its sheath. Symptoms are localized around the Achilles tendon, and usually include a slow onset of pain, swelling, and warmth. Overuse or strenuous exercise tend to aggravate symptoms.
Parkes Weber syndrome
A combined vascular malformation that is often confused with Klippel-Trénaunay syndrome. Both conditions primarily affect the limbs and result in abnormal growth of soft tissue and bone. However, the latter is a slow-flow combined CLVM (meaning it has capillary, lymphatic, and venous elements), whereas Parkes Weber syndrome is a fast-flow combined CAVM (or capillary-arteriovenous malformation).
Periodic limb movement disorder (PLMD)
Involuntary periodic movements (eg, twitching or jerking) in lower extremities (usually legs) during sleep; usually involves extension of the big toe, and flexion of ankles, knees, and hips. Diagnosis is made when the Periodic Limb Movement Index (PLMI), a recording of the number of leg movements during sleep, exceeds 5 leg movements per hour in children and 15 per hour in adults.
Periodic limb movement index (PLMI)
Number of leg movements during each hour of sleep.
Periodic limb movements in sleep (PLMS)
Involuntary periodic movements in the lower extremities (usually legs) during sleep; usually involves big toe extension, bilateral ankle dorsiflexion,
knee flexion, and hip flexion. Limb movements last 0.5 to 5 seconds; movements occur every 5 to 90 seconds, and typical movements occur between
20 to 40 seconds.
Peripheral arterial disease (PAD)
A form of peripheral vascular disease (PVD) in which there is damage to or narrowing of the blood vessels that transport blood away from the heart to the arms or legs. PAD is a coronary artery disease risk equivalent.
Peripheral nervous system
A part of the body’s nervous system that consists of the nerves and neurons that reside or extend outside of the central nervous system to serve the limbs and organs.
Peripheral neuropathy
A condition caused by damage to the nervous system, which includes nerves that run from the brain and spinal cord to the rest of the body; usually begins in the hands, feet, and/or legs, with symptoms of numbness, tingling, burning, or weakness. Neuropathy may affect one nerve (mononeuropathy) or several nerves (polyneuropathy) in the peripheral nervous system. More than 100 types have been identified; often affects people with diabetes and autoimmune disease.
Peripheral vascular disease (PVD)
A disease of the blood vessels outside the heart and brain affecting peripheral circulation; damage to or blockage in the veins that transport blood from the arms and legs back to the heart. PVD is sometimes incorrectly used as a synonym for peripheral arterial disease (PAD).
Peritonitis
Occurs when the peritoneum (or the tissue lining the abdomenopelvic walls and covering the abdominal organs) becomes inflamed. Symptoms can include a fever, thirst, low urine output, and nausea and vomiting. Treating peritonitis usually involves surgery and antibiotics. Also known as "acute abdomen."
Persistent sciatic artery
A rare vascular anomaly that occurs when the lower limb continues to receive its major blood supply from the internal iliac artery and the embryonic axial artery after birth. Persistent sciatic artery can threaten the viability of the lower extremity.
Piriformis syndrome
Piriformis syndrome can cause pain in the buttocks, along the back of the leg, and in the foot. The condition results from irritation of the sciatic nerve by the piriformis muscle, and it is believed to occur commonly in runners, walkers, and other active individuals.
Plantar fasiitis
Heel pain that occurs when the fascia–fibrous tissue covering the bones on the underside of the foot–becomes inflamed. Among the people most at risk are those with foot arch problems, those who are obese, and those with a tight Achilles tendon. Treatment can include rest, ice massage, arch supports, casting, and therapy with nonsteroidal anti-inflammatory medications (NSAIDs) or corticosteroids.
Popliteal (artery) entrapment
A rare condition in which the popliteal artery is repeatedly compressed behind the knee during exercise. Symptoms may include claudication and tingling or coldness in the foot. Popliteal entrapment can potentially cause permanent damage to the artery.
Primary restless legs syndrome (RLS)
The most common type of RLS (also known as idiopathic RLS); usually a lifelong condition with no known cause. Over time, symptoms tend to worsen and occur more often, especially if they begin in childhood or early in adult life. In milder cases, there may be long periods of time without symptoms, or symptoms may last for only a limited time. See also: Restless legs syndrome.
Pseudo-Kaposi's sarcoma
Pseudo-Kaposi's sarcoma is a benign legion that mimics the potentially life-threatening cancer Kaposi's sarcoma. Because the two lesions closely resemble each other both clinically and histopathologically, they can be incorrectly diagnosed. Among the key traits that distinguish Pseudo-Kaposi's sarcoma from Kaposi's sarcoma are the absence of slit-like vessels and a lack of progression or cell proliferation. Also called "acroangiodermatitis."
Pulmonary embolism (PE)
A manifestation of venous thromboembolism (VTE); PE occurs when a segment of a blood clot within the deep venous system detaches from the vessel, travels to the lungs, and lodges within the pulmonary arteries.
Repetitive motion disorders
Muscular conditions caused by repetitive motions carried out as part of normal daily activities (including work). Achilles tendinopathy and pes anserinus tendinitis/bursitis (PATB) are two examples that affect the legs. Treatment focuses mainly on reducing or stopping the motions that induce symptoms. Most people recover completely.
Restless legs syndrome (RLS)
An uncontrollable urge to move the legs in a person at rest (typically during the night); usually accompanied or caused by uncomfortable and unpleasant feelings in the legs (eg, itching, pain); rest or inactivity precipitates or worsens symptoms. There are two types of RLS:
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Primary (or Idiopathic) RLS is the most common type; its cause is unknown. Once it manifests, primary RLS usually becomes a lifelong condition. Over time, symptoms tend to worsen and occur more often, especially if they begin in childhood or early in adult life. In milder cases, there may be long periods without symptoms, or symptoms may last for only a limited time.
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