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Abstract
The misuse of medical and legal terminology can be confusing and frustrating and also introduces the potential for errors; this article focuses on some of the most often misused terms applicable to injury and illness. A common example of anatomical imprecision involves the shoulder, and patients who complain of “shoulder pain” sometimes localize their discomfort in the trapezius or scapula rather than on the shoulder per se. The distinction between shoulder and upper back or shoulder girdle pain is not merely terminological nitpicking but rather is of clinical significance. Similarly, no terms are more commonly misused than “arm” and “leg.” The most misused terms in musculoskeletal pathology are those related to disc lesions, and one commonly hears that a magnetic resonance image (MRI) scan was ordered “to rule out a disc,” but having a disc is neither an indication for MRI nor surgery. Further imprecise terminology leads to semantic imprecision when terminology is incorrectly used, including intervertebral disc, bulge, protrusion, extrusion, sequestered fragment, hernia, rupture, and even fracture. Physician evaluators and health care providers must understand that—by virtue of the authority vested in them and the weight given to their opinions by claims personnel, attorneys, judges, and others—errors and injustices may occur if they do not understand or correctly use medicolegal terms.
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1.
Brooks CN, Funk JR, Melhorn JM, Talmage JB, Brigham CR. Do rear-end collisions cause rotator cuff tears? Guides Newsletter. January–February 2014.
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Tempelhof S, Rupp S, Seil R. Age-related prevalence of rotator cuff tears in asymptomatic shoulders. J Shoulder Elbow Surg. 1999; 8:296–299.
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Minagawa H, Yamamoto N, Abe H, et al.Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population: From mass-screening in one village. J Orthop. 2013; 10:8–12.
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Stedman's Medical Dictionary, 26th ed. Williams & Wilkens: Baltimore, MD; 1995, p. 875.
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http://apps.leg.wa.gov/RCW/default.aspx?cite=51.08.100Washington State Legislature RCWs > Title 51 > Chapter 51.08 > Section 51.08.100 Accessed 11 Dec 2017
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https://www.dol.gov/owcp/dfec/regs/compliance/DFECfolio/FECA-PT2/group5.htm#20200United States Department of Labor Office of Workers' Compensation Programs Division of Federal Employees' Compensation Accessed 11 Dec 2017
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https://www.dol.gov/brb/References/Reference_works/lhca/lsdesk/DBSEC2.pdf Accessed 11 Dec 2017
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https://www.dol.gov/owcp/dlhwc/lhwca.htm#902United States Department of Labor Section 2(2) - Injury Accessed 11 Dec 2017
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http://www.un.org/esa/socdev/enable/dis50y10.htmUnited Nations enable The United Nations and Disabled Persons - The First Fifty Years Accessed 11 Dec 2017
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