Epicondylitis - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Epicondylitis typically occurs during the 4th and 5th decades of life. Patients describe a history of activities contributing to overuse of the forearm muscles that originate at the elbow.
People with lateral epicondylitis experience tenderness approximately 1 cm distal and anterior to the lateral epicondyle. They report pain during resisted wrist and digit extension, and during passive wrist flexion with the elbow extended.
People with medial epicondylitis have tenderness along the medial elbow, approximately 5 mm distal and anterior to the medial epicondyle. Pain is exacerbated with resisted forearm pronation and resisted wrist flexion.
Most patients will have complete resolution of symptoms with arm rest and nonsteroidal anti-inflammatory drug therapy. Patients with continued symptoms may require further treatment, including physical therapy, injection therapy, or surgical debridement.
The principal complication is continued pain. All other complications may arise from interventions attempting to alleviate the pain.

AP radiograph of elbow with lateral calcification from chronic lateral epicondylitis

From the collection of Daniel J. Solomon, Naval Medical Center San Diego, CA; used with permission

Quick Reference

History & Exam
- Key Factors
- Other Factors
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Diagnostics Tests
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Treatment Options
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Coronal MRI and axial MRI in the same patient, showing high signal in extensor carpi radialis brevis
Superficial muscles on the back of the left arm
$Surgery for refractory medial epicondylitis: probe placed on area of degenerative tendon showing los$
Surgery for refractory medial epicondylitis: probe placed on area of degenerative tendon showing loss of normal tendon appearance
Superficial muscles on the front of the left arm
$Surgery for refractory medial epicondylitis: pickups lifting off area of degenerative tendon after e$
Surgery for refractory medial epicondylitis: pickups lifting off area of degenerative tendon after elliptical incision to excise this area
AP radiograph of elbow with lateral calcification from chronic lateral epicondylitis
$Markings for swing incision location for patient with chronic refractory medial epicondylitis$
Markings for swing incision location for patient with chronic refractory medial epicondylitis
$Surgery for refractory medial epicondylitis: degenerative tendon removed$
Surgery for refractory medial epicondylitis: degenerative tendon removed
$Surgery for refractory medial epicondylitis: medial epicondyle exposed$
Surgery for refractory medial epicondylitis: medial epicondyle exposed

Citations

Key Articles

Calfee RP, Patel A, DaSilva MF, et al. Management of lateral epicondylitis: current concepts. J Am Acad Orthop Surg. 2008;16:19-29.[Abstract]
Ciccotti MC, Schwartz MA, Ciccotti MG. Diagnosis and treatment of medial epicondylitis of the elbow. Clin Sports Med. 2004 Oct;23(4):693-705, xi.[Abstract]
American College of Radiology. Practice parameter for the performance and interpretation of magnetic resonance imaging (MRI) of the elbow. 2021 [internet publication].[Full Text]
Raman J, MacDermid JC, Grewal R. Effectiveness of different methods of resistance exercises in lateral epicondylosis - a systematic review. J Hand Ther. 2012 Jan-Mar;25(1):5-25.[Abstract]

Referenced Articles

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