[Epicondylitis humeri (tennis elbow)].
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Abstract:
Epicondylitis is mostly related to a tendinosis found in the region of the radial or ulnar epicondylus, where the common origin of the extensor or flexor muscles is anchored. Several causes are associated with the etiopatho-genesis, most important is mechanical stress. The working hand is involved in the majority of cases. The age of the patients ranges mainly from 40-60 years. In 90% of the cases conservative measures are successful; if surgical treatment is necessary we recommend a modified version of Hohmann's operation.Keywords:
Epicondylitis
Tennis elbow
Tendinosis
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This chapter discusses sonographically guided elbow, tendon, and joint procedures used in the management of patients presenting with tendon and joint disorders of the elbow. Two sonographically guided corticosteroid injection techniques have been used for common extensor tendinosis, a superficial technique and a deep technique. Sonographically guided percutaneous longitudinal tenotomy has also been described for chronic flexor-pronator tendinosis. Distal biceps tendinopathy is a broad term that includes both inflammatory (tendinitis) and chronic degenerative (tendinosis) conditions. As the proximal portion of the distal biceps tendon can be easily palpated anteriorly, an anterior injection approach will typically provide uncomplicated access to the tendon and/or adjacent bursal fluid. Common elbow conditions are amenable to intra-articular elbow aspiration and injections (typically with corticosteroid).
Tendinosis
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Biceps tendon
Epicondylitis
Tendonitis
Tennis elbow
Tenotomy
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Epicondylitis is mostly related to a tendinosis found in the region of the radial or ulnar epicondylus, where the common origin of the extensor or flexor muscles is anchored. Several causes are associated with the etiopatho-genesis, most important is mechanical stress. The working hand is involved in the majority of cases. The age of the patients ranges mainly from 40-60 years. In 90% of the cases conservative measures are successful; if surgical treatment is necessary we recommend a modified version of Hohmann's operation.
Epicondylitis
Tennis elbow
Tendinosis
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Citations (2)
Corticosteroid injections are commonly administered to athletes to relieve symptoms of lateral elbow tendinosis. This report presents a case of almost total rupture of the common extensor origin in a 45 year old female squash player secondary to such a procedure.
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The aim of this study was to determine the value of measuring common extensor tendon (CET) thickness at the radiocapitellar and capitellar regions with qualitative ultrasonographic findings in the diagnosis of lateral elbow tendinopathy.The study included 164 lateral elbow tendinopathy patients (84 bilateral, 80 unilateral) matched by age, gender, and body mass index with 80 normal subjects. CET was examined using gray-scale and Doppler ultrasonography for tendinopathy, and tendon thickness was measured at two landmark locations: capitellar and radiocapitellar.In tendinopathy, tendon thickness including the dominant capitellar region, increased in every measured location. In the capitellar region of the dominant elbow, the cut-off thickness was 5.15 mm, and in the radiocapitellar region, this value was 4.05 mm. For the non-dominant elbow, the cut-off thickness was 4.61 mm, whereas in the radiocapitellar region, this value was 3.51 mm. The greatest risk of tendinopathy was at the radiocapitellar region on the dominant side. The overall sensitivity and specificity of gray-scale findings were 54% and 88%, respectively, and the addition of Doppler readings did not alter these values. When capitellar measurements were added, the values increased to 79% and 80% for sensitivity and specificity, respectively. These values further increased to 93% and 91%, respectively, when radiocapitellar measurements were included.A second tendon thickness measurement at the radiocapitellar region of CET in addition to the capitellar region is recommended on the grounds that combined qualitative and quantitative evaluation of CET increases the diagnostic per- formance of ultrasonography in lateral elbow tendinopathy.
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Lateral elbow tendinopathy (LET) seems to be the most appropriate term to use in clinical practice because previous terms such as lateral epicondylitis, tennis elbow, lateral epicondylalgia, epicondylosis, enthesopathy, Father of the Bride's Elbow, lateral elbow or extensor tendonitis, lateral elbow or extensor tendinosis, and extensor tendinopathy make reference to inappropriate aetiological, anatomical, and pathophysiological terms [...].
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