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Medical Glossary - R

  • radial tunnel syndrome
    This is caused by pressure on the posterior interosseous nerve within the tunnel formed by five anatomical structures at the lateral epicondyle (outer aspect of the elbow) and is the explanation for one of the many causes of pain in the elbow. Diagnostically the pain is worsened if the middle finger is pressed backwards and improved by anaesthetic block within the radial tunnel. The syndrome may be work related and tends to improve with rest. Surgery may help by decompressing the posterior interosseous nerve within the radial tunnel. But it may not. The use of local anti-inflammatory drugs may also be beneficial.

  • radicular pain
    As far as the upper limbs are concerned this is pain due to pressure or entrapment of the cervical nerve roots. The nerve roots can be nipped by being stretched over a disc herniation or compressed by disc material or bony encroachment into the intervertebral foramen.

  • radiculopathy
    This refers to the actual pathological process which causes the radicular pain. It may be due to disease, compression, or reduction in local blood supply by other causes.

  • ramazzini
    Bernardino Ramazzini (1633-1714) is described as the father of occupational medicine. He was professor of medicine at the University of Modena and later in Padua. His great work De MorbisArttj'tcum Diatriba is one of the most important books in the history of medicine. He was well in advance of his times and investigated the medical aspects of a great many of the occupations then current in Italy. He stated:
    'Medicine, like jurisprudence, should make a contribution to the well being of workers and see to it that, so far as possible, they should exercise their callings without harm.'

  • raynaud's phenomenon or disease
    This was named after Dr Maurice Raynaud who in 1862 wrote a thesis entitled De L’ Asphyxia Locale et de la Gangrene Symetrique des Extremities. It is peripheral vascular disturbance probably due to abnormal activity of the vasoconstrictor nerves which leads to constriction of the arteries in the fingers and thumb, precipitated by cold, emotion and by many other factors (see Vibration White Finger). The digits become blanched, painful and cold and in severe cases it can lead to gangrene. It also follows any hand surgery in about 2% to 3% of patients and there is no way of predicting who will be affected.

  • referred pain
    This pain manifesting itself at a distance from the actual nerve root compression or nerve injury.

  • reflex sympathetic dystrophy
    This is an unpleasant complication which may follow fractures about the wrist. In its early stages the condition is characterized by swelling of the soft tissues, exquisite tenderness to pressure, and pain on motion. Later, circulatory changes occur in the soft tissues and bone, the skin becomes purplish and cold, and there may be excessive perspiration. Much later the joints of the fingers and wrists become increasingly stiff and even the shoulder and elbow may be affected secondarily from voluntary immobilization of the arm in one position. X-rays reveal a mottled decalcification or osteoporosis of the bones. No treatment is entirely satisfactory but minimal immobilization with active and passive exercises, sympathetic blocks, and occupational and physical therapy seems to be as effective as any other treatment. Until symptoms and signs are relatively static, or a definite improvement is apparent, surgery should be delayed.

  • regional allodynia - regional pain disorder
    Diffuse pain and tenderness outside any single anatomical structure or boundary, worse with hand use but with little improvement in pain free function, even after prolonged reduction in hand use activities, even in the absence of any definable rheumatological or orthopaedic. This is a condition of unknown causation.

  • regional pain syndrome
    Pain often referred from a central point where there is an element of nerve entrapment.

  • repetitive strain injury
    This is the term previously given to damage to muscles, nerves, tendons, tendon sheaths or other soft tissues resulting from overuse or misuse usually in the upper limbs. The lower limbs, back shoulders and other parts of the body however, can also be affected. Unfortunately the term does not conform to conventional criteria for the description of disease and this can lead to confusion - particularly if litigation is contemplated - for it implies the existence of a physical condition with an identifiable cause. Physical signs may be imprecise or absent, the word 'strain' is not used in its true mechanical sense - but in a lay sense - and 'injury' suggests a single culpable event. However, the term 'RSI' has wide understanding in lay circles and the RSI Associations do valuable work for their members and it is reasonable that the term continues - if only to prevent it being replaced by something equally imprecise and providing the qualifications to its use are appreciated.

  • rheumatoid arthritis (ra)
    Rheumatoid arthritis is a chronic non-bacterial inflammation of joints which causes thickening of the synovial membrane and chronic inflammatory changes. The articular cartilages are later softened and eroded. Osteoarthritis may be due to occupational hazards leading to wear and tear in the joints but rheumatoid arthritis is a disease without any known occupational associations.

  • rotator cuff syndrome
    This refers to a cuff of soft tissue over the tip of the shoulder made up of the supra-spinatus tendon and the adjoining flat tendons which are blended together to form what is often called the rotator cuff Injury to the cuff produces pain at the tip of the shoulder reflecting down the upper arm, and the inability to abduct the arm without pain.