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Crepitus is "a grating sound or sensation produced by friction between bone and cartilage or the bone fracture parts of a bone".
Various types of crepitus that can be heard in joint pathologies are:
Crepitus can easily be created and observed by exerting a small amount of force on a joint, thus 'cracking joints'. This is caused by bubbles of nitrogen forming in the synovial fluid bursting. Almost every joint in the body can be 'cracked' in this way, but the joints which require the least amount of force to produce this effect include the hallux (big toes), the and the neck joints. This phenomenon is caused when the movement of the joint lowers the pressure of its synovial fluid, causing the bubbles to form and burst. A refractory period of about 20 minutes exists where the joint cannot be stimulated to produce crepitus after being cracked until the nitrogen gas dissolves back into the synovial fluid.
In soft tissues, crepitus can be produced when gas is introduced into an area where it is normally not present.
The term can also be used when describing the sounds produced by lung conditions such as interstitial lung disease; these are also referred to as "rales". Crepitus is often loud enough to be heard by the human ear, although a stethoscope may be needed to detect instances caused by respiratory diseases.
In times of poor surgical practice, post-surgical complications involved anaerobic infection by Clostridium perfringens strains, which can cause gas gangrene in tissues, also giving rise to crepitus.
Subcutaneous crepitus (or surgical emphysema) is a crackling sound resulting from subcutaneous emphysema, or air trapped in the subcutaneous tissues.
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