M

maceration increase in bulk (with softening) of the stratum corneum; caused by prolonged exposure to sweat or induced by topical application of hydrolysing or caustic chemicals, in treatment of verrucae or corn

macrocirculation circulation of blood through larger vessels (arteries and veins) – see microcirculation

macrocyte; megaloblast abnormal, large erythrocyte characteristic of pernicious anaemia

macroglossia tongue enlargement, as in hypothyroidism

macrolides class of antibiotic with similar activity to penicillin, e.g. erythromycin, clarithromycin

macromelia abnormal enlargement of one limb; rare cause of leg length discrepancy

macromolecule large molecule, e.g. a protein, globulin, nucleic acid or polysaccharide

macroonychia see onych-

macrophage large, mononuclear, amoeboid phagocytic and multifunctional cell; has a major role in inflammation and tissue repair (identifies and engulfs dead/damaged cells, destroys microorganisms, synthesizes and releases chemical mediators of inflammation, initiates immune response to invading microorganisms, initiates tissue regeneration [releases growth factors and chemoattractants for fibroblasts] involved in tissue repair)

macroscopic visible to the naked eye

macrovascular disease see atherosclerosis

macula small, sessile, discoloured skin patch

macula lutea oval area of retina adjacent to optic disc

maculopapule broad-based, sessile skin lesion with central raised papule

maculopathy any pathological condition of macula lutea; e.g. diabetic retinal disease

Madura foot tropical deep infection (e.g. of a penetrating wound) with Madurella fungus, characterized by necrosis, chronic pus and sinus formation, and gross foot swelling

maggot therapy see larval therapy

magnesium sulphate see Epsom salts

magnetic resonance imaging scan; MRI scan non-ionizing imaging modality; body part under investigation is subjected to electromagnetic pulses (hydrogen ions and protons align and emit detectable radio waves), building a tissue ‘picture’ in 3- or 5-mm-wide sections

Magnetopulse device generating a pulsed magnetic field within targeted tissues; used to gain symptomatic relief of injury and inflammation, or to increase blood flow to specific tissue areas (Table M1); contraindicated in diabetes, pacemakers, pregnancy or history of thrombosis

Table M1 Examples of Magnetopulse treatment regimes

‘major tranquillizers’ see neuroleptics

-malacia softening/loss of tissue consistency/contiguity, e.g. osteomalacia; chondromalacia

malalignment injury foot, lower-limb or back injury due to positional compensation, e.g. excessive foot pronation, tibial varum, genu valgum, degenerative joint disease or structural anomaly

malar rash butterfly rash or facial vasculitis characteristic of autoimmune disease, e.g. systemic lupus erythematosus

Malassezia furfur causative fungal organism of pityriasis versicolor (tinea versicolor), see pityriasis versicolor

malathion topical treatment for ectoparasite infection (e.g. scabies, head and body lice [crabs])

malformation failure of normal development

malignant locally invasive, destructive, neoplastic growth; can undergo metastasis

malignant melanoma see melanoma

malleolar arteries anterior tibial artery branches forming medial and lateral malleolar arteries (latter anastomoses with perforating branch of peroneal artery)

malleoli (singular: malleolus) rounded bony process at distal end of leg, marking medial and lateral ankle joint borders

mallet toesee toes Table L1

mal perforans neuropathic perforating (trophic) ulcer, with exposure of deep structures (plantar fascia, tendons, joint ligaments or bone); often complicated by deep soft-tissue and bone infection

malpighian body tuft of capillary loops within and surrounding Bowman’s capsule that together form the beginning of a renal nephron

malunion incomplete/misaligned post-injury bone union

management plan; MP proposed and written course of short-term and long-term treatment regimes linking the patient examination and diagnosis to resolution of patient’s presenting condition; should be agreed by both practitioner and patient, and include an outline of all treatments likely to be included, estimates of treatment success rates, likelihood of recurrence of condition and/or need for further or ongoing treatments, and the frequency of those treatments; it should also note any items of (written) information or verbal advice given to the patient, specify any discipline to whom patient should be referred, and also detail any treatment area to be undertaken by the patient him- or herself; therapies indicated in the MP plan should be supported by evidence-based medicine, local protocols, treatment algorithms and similar; MP is retained in patient notes, copied to referring practitioner, reviewed regularly (e.g. after specified number of visits) and a list of the range of other possible options recorded if initial interventions are unsuccessful or problem recurs (e.g. referral to another specific discipline for a named form of therapy/advice) (Table M2)

Table M2 Example of a management plan for a child with nail pain

Manchester Foot Pain and Disability Questionnaire (MFPDQ) validated, foot-specific outcomes measure, used to assess impact of rheumatoid disease and other painful foot conditions

manic–depressive psychosis; bipolar disorder major, often remissive/recurrent mental illness, characterized by severe mood changes

manoeuvre planned movement

Manusept see triclosan

march fracture see fracture, march

Marfan’s syndrome see syndrome, Marfan’s

Marjolin’s ulcer see ulcer, Marjolin’s

marrow soft, fatty, haemopoietic tissue within medullary cavity of long bones

mask (1) device covering nose and mouth, facilitating administration of mouth-to-mouth assisted respiration (e.g. Leyerdahl mask), as part of infection control protocol, or to prevent inhalation of particulate matter

mask (2) several layers of adhesive strapping (with a central hole, matching lesion size); protects surrounding skin from effects of ointment-based caustic agents applied to e.g. verrucae; Figure M1

Figure M1 Mask: several layers of adhesive strapping with a central hole into which a caustic ointment is placed (A), overlain by a cavitied felt pad (B), strapped into place (C). This article was published in Neale’s Disorders of the Foot, Lorimer, French, O’Donnell, Burrow, Wall, Copyright Elsevier, (2006).

mass amount of matter contained by an object

matrix tissue formative element

mattress sutures interrupted sutures that cause minimal tension at wound edges; see Figure H4; Table S6

maturity-onset diabetes mellitus outdated term for type 2 diabetes mellitus

maturity-onset diabetes of the young; MODY presentation of type 2 diabetes mellitus affecting overweight young adults or teenagers, similar to type 2 diabetes of older subjects, but usually without secondary complications (see also diabetes mellitus and type 2 diabetes mellitus)

maximum safe dose; MSD body mass-related maximum dose (of a pharmacological agent) that can be administered within a 24-hour period, usually quoted for a 70-kg adult; calculated as the product of body mass and the amount or percentage mass of drug used (Tables M3–M5); MSD cannot be increased in a patient weighing >70 kg, and must be reduced proportionally for patients weighing <70 kg, or with reduced liver/kidney function, or concurrently using e.g. beta-blockers, antiarrhythmic drugs or central nervous system-acting drugs (Table M3)

Table M3 Maximum safe doses of plain local anaesthetic agents (for 70 Kg adult in 24 hours)

Table M4 Calculation of the combined maximum safe doses (MSDs) of plain local anaesthetic agents

Table M5 Calculation of the percentage mass of solute in solution

Mayo block; first-ray block see anaesthesia, first-ray block

mean measure of central tendency; average value (i.e. sum of all values divided by number in sample); mean, median and mode are identical in normally distributed data

mean cell volume; MCV mean erythrocyte volume; calculated from the haematocrit and red cell count

measurements objective and numerical records, i.e. signs, questionnaire-derived data, body part dimensions (e.g. leg length, shoe size, available subtalar joint inversion)

mechanics study of forces acting on objects, and effects induced by the application of force (e.g. movement, size, shape and structural effects)

mechanobullous skin disorders skin diseases characterized by epidermis or dermis fragility, or fragility of adhesion mechanism of epidermis on dermis, e.g. epidermolysis bullosa

mechanoreceptors specialized sensory nerve endings at termini of A-beta nerve fibres; preferentially subserve mechanosensation, e.g. touch, vibration (see Table S2)

medial ankle ligament see deltoid ligament; Table A7

medial arterial calcification; MAC see Mönckeberg’s sclerosis

medial collateral ligament of 1 MTPJ capsular thickening at medial aspect of first metatarsophalangeal joint (1 MTPJ), forming medial aspect of 1 MTPJ ‘socket’; blends with medial sesamoid ligament

medial column sagittal subdivision of the foot; formed of navicular, medial, intermediate and lateral cuneiforms, first, second and third metatarsals and their respective phalanges; articulates with hindfoot at talonavicular joint (i.e. midtarsal joint)

medial dorsal cutaneous nerve terminal branch of superficial peroneal nerve; innervates medial aspect of first ray and second intermetatarsal space; may become compressed (entrapped) at first metatarsal–medial cuneiform joint area, causing dermatomal distal paraesthesia and pain (see intermediate dorsal cutaneous nerve)

medial dorsal cutaneous nerve block see anaesthesia, superficial peroneal

medial eminence bony exuberance, frequently overlain by adventitious bursa, at medial aspect of first metatarsal head; characteristic of a bunion

medial flange see valgus pad

medial forefoot wedge wedge of material (clinical padding or orthosis) that fills the potential space between medial plantar forefoot and underlying support surface, and resists compensatory forefoot pronation; terminal part of medial sole wedge (see cobra pad)

medial gutter soft-tissue space between medial articular surface of talus and lateral articular surface of tibial malleolus

medial knee pain pain and discomfort at medial knee joint area, secondary to strain imposed by excess foot pronation (see Table K3)

medial longitudinal arch; MLA D-shaped concavity (in frontal and sagittal planes), at middle one-third of medial plantar aspect of foot; extends from distal limit of heel to just proximal to head of first metatarsal, and from medial (inner) border of foot to just medial to plantar cuboid (see Figure C3, Table A7)

medial longitudinal arch height sagittal-plane height of medial longitudinal arch is determined by calcaneal angle of inclination, talar pitch and first metatarsal angle of declination; the navicular functions as the arch ‘keystone’ (see Figure C3)

medial plantar artery terminal branch of posterior tibial artery, supplies medial aspect of hallux; anastomoses with first plantar metatarsal artery

medial plantar nerve medial division of terminal branches of tibial nerve; subserves medial plantar area, except medial area of medial longitudinal arch and plantar surface of heel (see Figure D1)

medial sole wedges see cobra pad

medial support strapping soft splint formed from 2.5-cm-wide elastic strapping, applied as a ‘stirrup’ to hind- and midfoot (with foot held in inversion; ± valgus filler pad) as short-term management of chronic medial ankle pain/trauma, or chronic plantar fasciitis (Figure M2)

Figure M2 Medial support strapping A: valgus filler pad; B: tension strap to invert foot; C: retaining straps; D: ‘Figure of 8’ tension strap to maintain foot inversion. This article was published in Neale’s Disorders of the Foot, Lorimer, French, O’Donnell, Burrow, Wall, Copyright Elsevier, (2006).

medial (tibial) sesamoid ligament ligament suspending medial side of medial sesamoid; blends with medial collateral ligament of first metatarsophalangeal joint

medial tibial stress syndrome; MTSS see syndrome, medial tibial stress (Tables M6 and M7)

Table M6 Grades and characteristics of medial tibial stress syndrome (MTSS)

Table M7 Phased treatment approach to medial tibial stress syndrome (MTSS)

median middle value in range of measurements; mean, median and mode are identical in normally distributed data

median line of foot imaginary line bisecting foot longitudinally, from central heel to second/third webspace

median plane see cardinal planes of the body

Medical Devices Agency; MDA UK competent authority for manufacture of medical devices (e.g. bespoke orthoses); EEC Directive 93/42 requires that all manufacturers are registered with the MDA, and that all manufactured orthoses carry the CE mark (see Box C1)

medical emergencies unexpected clinical emergencies arising as a result of, or during, treatment (Table M8)

Table M8 Actions to minimize the incidence of medical and clinical emergencies

Medical Exposures Directive Council Directive 97/43/Euratom of 30 June 1997; revoked 1988 Ionizing Radiation Regulations

medical history information given by patient (and/or patient’s partner/carer/parent/referring practitioner), detailing the patient’s current and past health status (Table M9)

Table M9 The medical history

medicine treatment of disease

Medicines and Healthcare products Regulatory Agency (MHRA) UK authority governing access to provision and use of medicines and health care products

medicolegal legal requirements inherent within practice of podiatry

mediolateral oblique projection see Table R1

medulla oblongata lowest subdivision within brainstem, continuous with spinal cord; extends from decussation of pyramids to pons

mefenamic acid; Ponstan non-steroidal anti-inflammatory drug indicated for mild/moderate pain relief in rheumatoid arthritis, osteoarthritis and postoperative analgesia

megakaryocyte large nucleated cell within bone marrow (but not circulating blood), fragments of which form platelets

megaloblast see macrocyte

meiosis reduction division; see chromosomes

Meissner corpuscles specialized endings at A-beta sensory nerves; lie within upper poles of dermal papillae; subserve light touch skin sensation Table S2

Melaleuca alternifolia tea tree bush

melalgia claudicating pain extending from feet into legs, characteristic of arterial wall hypertrophy/vessel lumen obliteration

melanin dark brown/black pigment within melanosomes of epidermal melanocytes (see melanosome)

melanocytes neural tube-derived, melanin-producing cells of dermoepidermal junction and stratum germinativum; characterized by long branching dendritic processes (see melanosome)

melanoma malignant neoplasm of melanocytes; capable of widespread metastasis (see Table C13)

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