Pullistuminen

Pullistuminen is a term used in medical Finnish to describe bulging or protrusion of tissue beyond its normal boundary. It is commonly used for a protrusion of an intervertebral disc into the spinal canal, referred to in Finnish as välilevyn pullistuma. The process typically arises when the outer layer (annulus fibrosus) weakens or sustains tears, allowing the inner gel-like nucleus pulposus to bulge outward. Risk factors include aging, degenerative disc disease, repetitive loading, acute injury, and obesity. Symptoms depend on the level and may include local back or neck pain, radicular pain such as sciatica, numbness, tingling, or muscle weakness. Some bulges are asymptomatic and discovered incidentally.

Diagnosis relies on clinical assessment and imaging. MRI is the preferred modality to visualize soft tissue and the extent of a bulge; CT can be used when MRI is unavailable. X-ray may assess alignment or degenerative changes but does not show the soft tissue bulge. Treatment is typically conservative at first: physical therapy, activity modification, analgesics and anti-inflammatories, and possibly epidural injections. Most disc bulges improve within weeks to months. If neurological deficits worsen or persistent pain fails to respond, surgical options such as discectomy or decompression may be considered.

Pullistuminen may also describe bulging in other organs or vessel walls, such as aneurysm formation in arteries, or protrusion of a structure beyond its normal boundary in other contexts. In radiology reports the term indicates a protrusion rather than a rupture, and its clinical significance varies with size, location, and symptoms.