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The Language Of Medicine th 8 edition Davi-Ellen Chabner Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Chapter 15 The Musculoskeletal System Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Learning Objectives Define terms relating to the structure and function of bones, joints, and muscles. Describe the process of bone formation and growth. Locate and name the major bones of the body. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Learning Objectives (cont’d.) Analyze the combining forms, prefixes, and suffixes used to describe bones, joints, and muscles. Explain various musculoskeletal disease conditions and terms related to bone fractures. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Learning Objectives (cont’d.) Describe important laboratory tests and clinical procedures related to the musculoskeletal system, and recognize relevant abbreviations. Apply your new knowledge to understanding medical terms in their proper contexts, such as medical reports and records. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Chapter 15 Lesson 15.1 Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Introduction Musculoskeletal System: bones, muscles, and joints of the body Bones: structural support and protection of internal organs Muscles: internal and external movement Joints: where bones come together/type determined by need for flexibility Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Physicians Associated with Musculoskeletal System Orthopedist: MD, bones, bone disease Rheumatologist: MD, joints Osteopathic physician: DO, body able to heal itself with proper nutrition and bone alignment Chiropractor: physical manipulation of the spinal column to relieve pressures on nerves Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. BONE FORMATION Ossification: replacement of cartilage with bone Cells: osteoblast: produce immature bony tissue that replaces cartilage osteocyte: nourishes and maintains bone osteoclast: reabsorb or digest bone (remodels bone) Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. BONE FORMATION Osteoblasts and osteoclasts work to deposit and tear down bone throughout life. The skeleton is a source of calcium. Proper formation of bone depends on sources of calcium, phosphorous, and vitamin D. Calcium phosphate enzyme helps create hard bone from these sources. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. BONE FORMATION Reservoir for calcium storage Calcium necessary for nerve transmittal to muscle, including heart muscle and muscles attached to bones Calcium level maintained in blood by parathyroid gland, which secretes a hormone to release calcium from bone Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. BONE STRUCTURE Long, short, flat, sesamoid (in shape) Diaphysis: shaft Epiphysis: end Metaphysis: cone-like flared portion between end and shaft Epiphyseal line or plate: growth plate where cartilage replaced by bone for bone growth (in length) Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Bone Structure (cont’d.) (A) Divisions of a long bone and interior structure (B) composition of compact (cortical) bone Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Bone Structure (cont’d.) (A) Divisions of a long bone and interior structure (B) composition of compact (cortical) bone Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Bone Structure (cont’d.) Ends of bones covered by articular cartilage in the joint: cushions joint and allows it to move smoothly Compact bone: contains haversian systems for blood vessels, nerves, and yellow bone marrow (mostly fat) Cancellous (spongy/trabecular bone): spaces contain red bone marrow with elements for blood formation Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Bone Marrow Yellow marrow: chiefly fat Red marrow: rich with blood vessels and immature and mature blood cells in various stages of development; in later life replaced with yellow marrow Ribs, pelvic bone, sternum, vertebrae, epiphyses of long bones Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Bone Processes and Depressions Processes: serve as attachments for muscles and tendons Depressions: openings or hollow regions help join bones or serve as passageways for nerves and/or vessels Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Bone Processes and Depressions Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Bone Processes and Depressions Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Cranial Bones Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Cranial Bones Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Cranial Bones and Associated Structures Frontal bone Parietal bone Temporal bone Occipital bone foramen magnum Sphenoid bone temporomandibular (TMJ) joint mastoid process styloid process sella turcica Ethmoid bone Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Facial Bones Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Facial Bones Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Facial Bones (cont’d.) Nasal bones Lacrimal bones Maxillary bones Mandibular bones Zygomatic bones Vomer Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. SINUSES Air cavities located in facial and cranial bones. They lighten the skull and warm and moisten the air as it passes into the respiratory system. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Vertebral Column and Vertebrae Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Vertebral Column and Vertebrae (cont’d.) Vertebrae: 26 bone segments from base of skull to tailbone in five divisions and separated by pads of cartilage called intervertebral disks. Cervical, thoracic, lumbar, sacral Coccyx: tailbone Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. BONES Thorax, Pelvis and Extremities Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. BONES Thorax, Pelvis and Extremities Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Thorax, Pelvis and Extremities (cont’d.) Thorax Arm and Hand clavicle humerus Pelvis pelvic girdle scapula ulna ilium sternum radius ischium ribs carpals pubis metacarpals phalanges Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Bones of Leg and Foot Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Bones of Leg and Foot and Associated Structures Femur acetabulum Tarsals Patella Tibia medial malleolus calcaneus talus Metatarsals Phalanges Fibula lateral malleolus talus Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. QUICK QUIZ: 1. The knuckle-like process at the end of a bone near the joint… A. fossa B. condyle C. tubercle D. diaphysis Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. QUICK QUIZ: 2. Process of bone formation____________ A. olecranon B. ossification C. osteoblast D. xiphoid process Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS AND SUFFIXES GENERAL TERMS COMBINING FORMS Combining Form Meaning calc/o calci/o kyph/o lamin/o lord/o lumb/o Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS AND SUFFIXES GENERAL TERMS COMBINING FORMS Combining Form calc/o calci/o kyph/o lamin/o lord/o lumb/o Meaning calcium calcium posterior curvature in thoracic region lamina curve loins, lower back Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS AND SUFFIXES GENERAL TERMS COMBINING FORMS Combining Form Meaning myel/o orth/o oste/o scoli/o spondyl/o vertebr/o Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS AND SUFFIXES GENERAL TERMS COMBINING FORMS Combining Form myel/o orth/o oste/o scoli/o spondyl/o vertebr/o Meaning bone marrow straight bone crooked vertebra vertebra Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS AND SUFFIXES GENERAL TERMS SUFFIXES Suffix Meaning -blast -clast -listhesis -malacia -physis -porosis -tome Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS AND SUFFIXES GENERAL TERMS SUFFIXES Suffix Meaning -blast -clast -listhesis -malacia -physis -porosis -tome embryonic cell to break slipping softening to grow pore, passage instrument to cut Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS AND SUFFIXES TERMS RELATED TO SPECIFIC BONES COMBINING FORMS Combining Form Meaning acetabul/o calcane/o carp/o clavicul/o cost/o crani/o Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS AND SUFFIXES TERMS RELATED TO SPECIFIC BONES COMBINING FORMS Combining Form acetabul/o calcane/o carp/o clavicul/o cost/o crani/o Meaning acetabulum (hip socket) calcaneus (heal) carpals (wrist bones) clavicle (collar bone) ribs cranium (skull) Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS AND SUFFIXES TERMS RELATED TO SPECIFIC BONES COMBINING FORMS Combining Form Meaning femor/o fibul/o humer/o ili/o ischi/o malleol/o Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS AND SUFFIXES TERMS RELATED TO SPECIFIC BONES COMBINING FORMS Combining Form femor/o fibul/o humer/o ili/o ischi/o malleol/o Meaning femur (thigh bones) fibula (smaller lower leg bone) humerus (upper arm bone) ilium (upper part of pelvic bone) ischium (part of pelvic bone) malleolus Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS AND SUFFIXES TERMS RELATED TO SPECIFIC BONES COMBINING FORMS Combining Form Meaning mandibul/o maxill/o metacarp/o metatars/o olecran/o patell/o pelv/i Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS AND SUFFIXES TERMS RELATED TO SPECIFIC BONES COMBINING FORMS Combining Form mandibul/o maxill/o metacarp/o metatars/o olecran/o patell/o pelv/i Meaning mandible (lower jaw bone) maxilla (upper jaw bone) metacarpals (hand bones) metatarsals (foot bones) olecranon (elbow) patella (kneecap) pelvis Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS AND SUFFIXES TERMS RELATED TO SPECIFIC BONES COMBINING FORMS Combining Form Meaning perone/o phalang/o pub/o radi/o scapul/o Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS AND SUFFIXES TERMS RELATED TO SPECIFIC BONES COMBINING FORMS Combining Form perone/o phalang/o pub/o radi/o scapul/o Meaning fibula phalanges (finger, toe bones) pubis radius scapula (shoulder blade) Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS AND SUFFIXES TERMS RELATED TO SPECIFIC BONES COMBINING FORMS Combining Form Meaning stern/o tars/o tibi/o uln/o Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS AND SUFFIXES TERMS RELATED TO SPECIFIC BONES COMBINING FORMS Combining Form stern/o tars/o tibi/o uln/o Meaning sternum (breastbone) tarsals tibia (shin bone) ulna (lower arm bone) Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. PATHOLOGIC CONDITIONS Ewing sarcoma: malignant bone tumor This x-ray shows a malignant bone tumor (Ewing's sarcoma) of the upper arm bone (humerus). This type of tumor usually occurs during childhood and adolescence. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Osteogenic Sarcoma: malignant tumor arising from bone This x-ray shows a malignant bone tumor (osteogenic sarcoma) of the knee. This type of tumor is usually seen in adolescents (around 15 years old). This tumor extends from the bone into the surrounding tissue Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. osteomyelitis: inflammation secondary to infection osteomalacia: softening of bone Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Exostosis: bony growth on surface of bone Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Talipes: congenital abnormality of hind foot involving the talus (clubfoot) Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Pathologic Conditions Fractures of Bones Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Pathologic Conditions Normal Bone Bone with osteoporosis Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Intraosseous Infusion – insertion of a needle into the bone marrow to gain intravenous access Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Chapter 15 Lesson 15.2 Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Joints Joint (articulation): coming together of two or more bones Suture joints: immovable (skull) Synovial joints: freely movable (ball and socket types, e.g. hip or shoulder), (hinge type, e.g., elbow, knee, ankle) Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Synovial Joints Joint capsule surrounds bone Ligaments band bones together Bones covered by articular cartilage Synovial membrane lies under capsule and lines synovial cavity; filled with synovial fluid Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Bursae Closed sacks of synovial fluid with a synovial membrane located near, but not within a joint. Needed where sliding must take place Common sites: between tendons (connective tissue connecting muscle to bone) and bones between ligaments (binding bone to bone) and bone between skin and bones (with prominent bony anatomy) Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Joints Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. QUICK QUIZ: 3. Connective tissue that binds muscles to bones____________ A. ligament B. articulation C. synovial membrane D. tendon Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS AND SUFFIXES COMBINING FORMS Combining Form ankyl/o arthr/o articul/o burs/o chondr/o Meaning Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS AND SUFFIXES COMBINING FORMS Combining Form Meaning ankyl/o stiff arthr/o joint articul/o joint burs/o bursa chondr/o cartilage Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS AND SUFFIXES COMBINING FORMS Combining Form ligament/o rheumat/o synov/o ten/o tendin/o Meaning Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS AND SUFFIXES COMBINING FORMS Combining Form Meaning ligament/o ligament rheumat/o watery flow synov/o synovial membrane ten/o tendon tendin/o tendon Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS AND SUFFIXES SUFFIXES Suffix Meaning -desis -stenosis Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS AND SUFFIXES SUFFIXES Suffix Meaning -desis -stenosis to bind, tie together narrowing Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Pathologic Conditions Arthritis: inflammation of joints Ankylosing spondylitis: chronic progressive stiffening of joints, mostly spine Gouty arthritis: inflammation due to excessive uric acid in body Osteoarthritis (OA): loss of articular cartilage and formation of bone spurs at articular surfaces Rheumatoid arthritis (RA): autoimmune reaction against joint tissues (synovial membrane) Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Osteoarthritis and Rheumatoid Arthritis Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Osteoarthritis is a chronic disease of the joint cartilage and bone, often thought to result from "wear and tear" on a joint, although there are other causes such as congenital defects, trauma and metabolic disorders. Joints appear larger, are stiff and painful and usually feel worse the more they are used throughout the day. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Pathologic Conditions Bunion: swelling of medial aspect of joint between big toe and first metatarsal bone Dislocation: displacement of bone from a joint Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Carpal tunnel syndrome: compression of median nerve as it passes between ligament and bones and tendons of the wrist. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Pathological Joint Conditions (cont’d.) Carpal tunnel syndrome Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Pathologic Conditions Ganglion: a fluid-filled cyst arising from the joint capsule or a tendon in the wrist. Herniation of an intervertebral disk: abnormal protrusion of the disk into the neural canal or against spinal nerves. Lyme disease: recurrent arthritis, myalgia, malaise and neurologic and cardiac symptoms. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Pathologic Conditions (cont’d.) Sprain: trauma to joint with pain, swelling and injury to ligaments Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Muscle strain – overstretching of a muscle Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Systemic lupus erythematosus (SLE): chronic inflammatory disease involving joints, skin, kidneys, nervous system, heart and lungs affecting collagen in tendons, ligaments, bones, and cartilage all over the body Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Chapter 15 Lesson 15.3 Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Muscles Three types of muscles: striated, smooth, cardiac Striated: under voluntary control—they move all the bones as well as face and eyes Smooth: control is involuntary—they move internal organs (digestive tract, blood vessels, ducts of glands) Cardiac: not consciously controlled and found exclusively in the heart Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Types of Muscle Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Types of Muscle Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Named Skeletal Muscles Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Named Skeletal Muscles Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Actions of Muscles flexion extension abduction adduction rotation dorsiflexion plantar flexion supination pronation Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Actions of Muscles (cont’d.) Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. QUICK QUIZ: 4. Movement AWAY from the midline of the body____________ A. adduction B. abduction C. flexion D. dorsiflexion Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS, SUFFIXES, AND PREFIXES COMBINING FORMS Combining Form Meaning fasci/o fibr/o leiomy/o my/o Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS, SUFFIXES, AND PREFIXES COMBINING FORMS Combining Form fasci/o fibr/o leiomy/o my/o Meaning facia fibrous smooth muscle muscle Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS, SUFFIXES, AND PREFIXES COMBINING FORMS Combining Form Meaning myocardi/o myos/o plant/o rhabdomy/o Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS, SUFFIXES, AND PREFIXES COMBINING FORMS Combining Form myocardi/o myos/o plant/o rhabdomy/o Meaning heart muscle muscle sole of the foot skeletal muscle connected to bones Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS, SUFFIXES, AND PREFIXES SUFFIXES Suffix Meaning -asthenia -trophy Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS, SUFFIXES, AND PREFIXES SUFFIXES Suffix Meaning -asthenia -trophy lack of strength development, nourishment Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS, SUFFIXES, AND PREFIXES PREFIXES Prefixe Meaning abaddorsipoly- Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS, SUFFIXES, AND PREFIXES PREFIXES Prefixe abaddorsipoly- Meaning away from toward back many, much Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Pathologic Conditions Muscular dystrophy: group of inherited diseases with progressive muscle weakness and degeneration without nervous system involvement Polymyositis: chronic inflammatory myopathy; may be an autoimmune disorder Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Laboratory Tests Related to Muscle Antinuclear antibody test (ANA) Erythrocyte sedimentation rate (ESR) Rheumatoid factor test (RF) Serum calcium (Ca) Serum creatine kinase (CK) Uric acid test Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Clinical Procedures Related to Bones, Joints, and Muscle Arthrocentesis Arthrography Arthroplasty Arthroscopy Bone density test Bone scan Computed tomography (CT) Diskography Electromyography (EMG) Magnetic resonance imaging (MRI) Muscle biopsy Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
