Rule 1Keep the combining vowel between a root and a suffix that begins with a consonant. arthr/o + -scopy = arthroscopy.
Rule 2Drop it when the suffix begins with a vowel. arthr/o + -itis = arthritis, never arthroitis.
Rule 3Keep it between two roots, even when the second root starts with a vowel. oste/o + arthr/o + -itis = osteoarthritis.
PrefixesStand outside the system entirely. They attach straight to what follows: sub/lingual, peri/cardium, hyper/tension.