LATERAL AND MEDIAL EPICONDYLITIS

Question 1

Lateral is also known as

Answer 1

Tennis Elbow

Question 2

What causes lateral epi.

Answer 2

Overuse injury involving excessive use of the extensor tendons

(1) Recall that extensor tendons are located just distal to the lateral epicondyle.
(2) Commonly seen in sports or activities that require excessive wrist and hand extension

Question 3

Lateral Epicondylitis:

Signs and Symptoms

Answer 3

Gradual onset of pain in lateral elbow and forearm during
activities involving gripping and wrist extension
`

Question 4

Lateral Epicondylitis:

Causes

Answer 4

(a) Lifting
(b) Turning screwdriver
(c) Hitting backhand in tennis
(d) Excessive typing
(e) Less common, results from direct blow to lateral aspect of elbow

Question 5

Lateral Epicondylitis:
Physical Exam
(1) Visual
(2) Palpation
(3) ROM
(4) Muscle Test
(5) Neurovascular
(6) Special Tests
(7) Diagnostic Tests

Answer 5

(1) Typically unremarkable
(2) 1) Tenderness over common extensor origin. 1cm distal and slightly anterior to lateral epicondyle
(3) Full AROM
(4) Wrist extension and grip strength limited by pain
(5) Typically unremarkable
(6) Pain in lateral epicondyle with resisted extension of the wrist
(7) Diagnosed clinically, Ultrasound/MRI in cases not responding to conservative management

Question 6

Lateral Epicondylitis

Treatment

Answer 6

(a) Light duty/duty modifications
(b) NSAIDS
(c) Tennis elbow strap for comfort
(d) Pain free stretching and forearm strengthening
(e) Consult to physical therapy if conservative management fails
(f) Ortho consult if no improvement
(g) Steroid injections

Question 7

Lateral Epicondylitis

Referral/Red Flags

Answer 7

(a) Failure of conservative management indicates need for further evaluation.

Question 8

Medial Epicondylitis:

AKA

Answer 8

Golfer’s elbow, bowler’s elbow

Question 9

Medial Epicondylitis:

Def

Answer 9

an overuse injury involving excessive use of the flexor and pronator
muscles just distal to the medial epicondyle

Question 10

Medial Epicondylitis:
Clinical Symptoms
Gradual onset of pain at medial aspect of elbow. Exacerbated
by activities that involve wrist flexion and forearm pronation.

Answer 10

(a) Golf swing
(b) Baseball pitching
(c) Pull-through stroke of swimming
(d) Weight-lifting
(e) Bowling
(f) Many forms of manual

Question 11

Medial Epicondylitis:
Physical Exam
(1) Visual
(2) Palpation
(3) ROM
(4) Muscle Test
(5) Neurovascular
(6) Special Tests
(7) Diagnostic Tests

Answer 11

(1) Typically unremarkable
(2) Tenderness just distal to medial epicondyle
(3) Full AROM
(4) Wrist flexion and pronation limited by pain
(5) Typically unremarkable
(6) Pain in medial epicondyle with resisted flexion of the wrist
(7) Diagnosed clinic, Ultrasound/MRI in cases not responding to conservative management

Question 12

Medial Epicondylitis:

Treatment

Answer 12

(a) Light duty/duty modifications
1) Limit repetitive activity to allow for healing
(b) NSAIDS
(c) Tennis elbow strap for comfort
(d) Pain free stretching and forearm strengthening
(e) Consult to physical therapy if conservative management fails
(f) Ortho consult if no improvement
(g) Steroid injection

Question 13

Medial Epicondylitis:

Red Flags/Referral

Answer 13

Failure of conservative management indicates need for further evaluation