Elbow pain

Question 1

Pain and tenderness localised to the lateral epicondyle

Pain worse on resisted wrist extension with the elbow extended or supination of the forearm with the elbow extended

Episodes typically last between 6 months and 2 years. Patients tend to have acute pain for 6-12 weeks

Answer 1

Tennis elbow

Lateral epicondylitis

Question 2

Pain and tenderness localised to the medial epicondyle

Pain is aggravated by wrist flexion and pronation

Symptoms may be accompanied by numbness / tingling in the 4th and 5th finger due to ulnar nerve involvement

Answer 2

Medial epicondylitis

(Golfer’s elbow)

Question 3

Most commonly due to compression of the posterior interosseous branch of the radial nerve. It is thought to be a result of overuse.

Features

• symptoms are similar to lateral epicondylitis making it difficult to diagnose
• however, the pain tends to be around 4-5 cm distal to the lateral epicondyle

symptoms may be worsened by extending the elbow and pronating the forearm

Answer 3

Radial tunnel syndrome

Question 4

Due to the compression of the ulnar nerve.

Features

• Initially intermittent tingling in the 4th and 5th finger
• May be worse when the elbow is resting on a firm surface or flexed for extended periods
• Later numbness in the 4th and 5th finger with associated weakness.

Answer 4

Cubital tunnel syndrome.

Question 5

Swelling over the posterior aspect of the elbow. There may be associated pain, warmth and erythema. It typically affects middle-aged male patients.

Answer 5

Olecranon bursitis