Epicondylitis

Question 1

What is another name for medial epicondylitis?

Answer 1

Golfer’s elbow

Question 2

What is medial epicondylitis?

Answer 2

inflammation of the common flexor origin on the medial head of the humeral epicondyle

Question 3

What causes medial epicondylitis?

Answer 3

Repetitive strain on the finger flexor tendons

Question 4

How will medial epicondylitis present?

Answer 4

medial elbow pain, with a tender point over the medial epicondyle, with pain aggrevated by wrist flexion and pronation

Question 5

What investigations are required in medial and lateral epicondylitis?

Answer 5

Clinical examination
USS and MRI if diagnosis uncertain
Nerve conduction study if nerve symptoms

Question 6

What is the main clinical examination in medial epicondylitis?

Answer 6

The patient supinating and flexing the elbow, before flexing the wrist

Resistance to extension should cause pain

Question 7

How is medial epicondylitis managed conservatively?

Answer 7

It is usually self limiting
- Rest
- Physiotherapy
- Injection of local anaesthetic and steroids
- Brace (Elbow clasp)

Question 8

How is refractory medial epicondylitis managed?

Answer 8

Surgical release in which some of the fibres of the common flexor origin are divided

Question 9

What is lateral epicondylitis also known as?

Answer 9

Tennis elbow

Question 10

What is lateral epicondylitis?

Answer 10

Inflammation of the common extensor origin of the finger extensor tendons at the lateral humeral epicondyle

Question 11

What usually causes lateral epicondylitis?

Answer 11

This is most commonly caused by repeated or excessive pronation or supination and extension of the wrist, such as in tennis players

This can result in formation of micro-tears in the common extensor origin

Question 12

How will lateral epicondylitis usually present?

Answer 12

This will usually present with pain and tenderness over the lateral epicondyle, with pain worse on stretching the extensor muscles

10-20% of cases are bilateral

Question 13

What is the main clinical examination in lateral epicondylitis?

Answer 13

The patient extending the wrist, and resisting flexion
This will cause pain

Question 14

What are some conservative managements for lateral epicondylitis?

Answer 14

This is usually self limiting
- Rest
- Physiotherapy
- Injection of local anaesthetic and steroids
- Brace (Elbow clasp)

Question 15

How may refractory lateral epicondylitis be managed?

Answer 15

Surgical release in which some fibres of the common extensor origin are divided