Regional Peri-Articular Pain - Elbow Flashcards
What are the peri-articular syndromes affecting the elbow?
Medial Epicondylitis
Lateral Epicondylitis
Olecranon Bursitis
What is Medial Epicondylitis?
Tendinopathy of common flexor-pronator origin, distal to bony prominence of medial epicondyle
What causes Medial Epicondylitis?
Recurrent microtrauma e.g. golf swings
How does Medial Epicondylitis present?
Pain developing over wks-mo, exacerbated by use & settling w/ rest
- v. severe
- radiates up/down arm
What are the signs on examination of Medial Epicondylitis?
Tenderness around medial epicondyle
Pain triggered by resisted flexion of hand
Normal range of movement
No neurological sx
What investigation may be appropriate in Medial Epicondylitis?
X-ray (to rule out OA)
What is the conservative management of Medial Epicondylitis?
NSAIDs Rest Physiotherapy Epicondylar clasp Steroid injection
What is the surgical management of Medial Epicondylitis?
Golfer’s Elbow release
- removal of abnormal looking tissue from tendon
- success rate >80%
What is Lateral Epicondylitis?
Tendinopathy of common extensor tendon origin, distal to lateral epicondyle
What is the epidemiology of Lateral Epicondylitis?
More common than Medial Epicondylitis
Peaks 40-60yrs
What are the risk factors for Lateral Epicondylitis?
Obesity
Smoking
Carpal tunnel Syndrome
Tendinopathies
What causes Lateral Epicondylitis?
Repetitive grasping/gripping movements
How does Lateral Epicondylitis present?
Pain around lateral epicondyle develops subacutely
- exacerbated by movement
- relieved by rest
- radiates up/down arm
What are the signs on examination of Lateral Epicondylitis?
Point tenderness distal to lateral epicondyle
Pain reproduced by resisted extension of wrist
Passive range of movement is normal
What is the conservative management of lateral epicondylitis?
NSAIDs Rest Physiotherapy Epicondylar clasp Steroid injection
