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n.1.See Spunk.
Webster's Revised Unabridged Dictionary, published 1913 by G. & C. Merriam Co.
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According to Racheal Spronk the challenge of sex research is to understand the ways how societal factors organize sex and sexuality and establish how these processes shape the experience of people (Sponk 2007:3).
The natural course of spontaneous osteonecrosis of the knee (SPONK): A 1- to 27-year follow-up of 40 patients.
Table 1 Imaging Characteristics of Bone Marrow Edema Imaging Modality Characteristic Radiograph Unremarkable; non-specific osteopenia T1 MRI Regional decreased signal intensity in bone marrow T2 MRI Regional increased signal intensity in bone marrow Table 2 Categories of Bone Marrow Edema Ischemic Mechanical Reactive Osteonecrosis Malalignment Infection Spontaneous osteonecrosis of Ligamentous/meniscal Osteomyelitis the knee (SPONK) injury Osteochondritis dissecans Bone contusion Inflammatory (OCD) arthritis Complex regional pain syndrome Overuse/stress Tumor (CRPS) injury Trauma/fracture
Villanueva takes on knockout artist Victor "Sponk" Mendez for the WBC international super flyweight championship while Melindo battles late replacement Victor Emanuel Olivo in a 10-round affair at the 112-lb division.
Spontaneous osteonecrosis of the knee (SPONK) and osteonecrosis in the postoperative knee (ONPK) both have the potential to progress to end stage degenerative changes, causing significant symptomatology that may eventually require operative intervention.
Examination of the affected knee in the acute phase of SPONK, typically the first 6 to 8 weeks following symptom onset, will demonstrate a small to moderate effusion with limitation of range of motion secondary to pain and associated muscle spasm.
With the majority of affected patients being elderly females with osteoporotic bone, some investigators believe that SPONK develops as a consequence of microfractures occurring in weak subchondral bone secondary to minor trauma.
Where a vascular etiology continues to be the dominant theory for osteonecrosis of the femoral head, with up to three-quarters of affected patients showing evidence of an underlying thrombophilia or coagulopathy, these predisposing factors have yet to be consistently demonstrated in patients with SPONK. (3,21) In the hip, many investigators believe that the presence of a coagulation disorder, including resistance of activated protein C, low tissue plasminogen activator activity, and hypofibrinolysis, causes intraosseous venous occlusion that culminates in the hypoxic death of bone.
(22-24) Case series have identified medial meniscal tears in 50% to 78% of patients of patients with SPONK with a recent series by Robertson and colleagues (24) noting that tears, specifically in the area of the meniscal root, coexisted with spontaneous osteoncecrosis in 24 of their 30 patients (80%).
In stage II SPONK, or the avascular stage, a round to oval subchondral lucency in the weightbearing area is present with associated increased density in the surrounding femoral condyle.
(3,25) Subtle flattening of the affected femoral condyle characterizes stage II SPONK, which indicates the potential for subsequent collapse.
(1,8,27) In many of the early studies of SPONK, the area of the lesion within the condyle was used to predict which cases would progress to severe degenerative arthritis.