Elbow tendon pathologies

Question 1

Lateral epicondylalgia most common tendon affected

Answer 1

ECRB

Question 2

Lateral epiconylalgia background

Answer 2

Common between ages of 30-50

Male=female

Often an overuse injury as a result of repititive activities

Question 3

Diagnosis of LE

Answer 3

-Pain over lateral epicondyle
-TTP of extensor tendon
-Pain with gripping, resisted wrist extension and resisted extension of 2nd or 3rd finger (3rd most common)

Question 4

Exam itens that may stand out for LEpicondylalgia

Answer 4

Pain with resisted wrist extension with elbow extended
Painful grip with reduced strength

+Cozen
+Maudsley’s
+Mill’s

Question 5

Cozen’s test

Answer 5

Pain to palpation while resisted wrist extension

Question 6

Maudsley’s test

Answer 6

Resisted 3rd finger extension

Question 7

Joint manipulation for the elbow and research

Mill’s
MWM
SLGWPFG

Answer 7

Mill’s- no long term effect

Mulligan’s and SLGWPFG
- some research in case series with improvements in Pain free grip, PPT and improved range with ULTT

Question 8

CS injection vs wait and see vs PT on lateral epicondylalgia

Answer 8

PT and wait and see had shown good long term improvements with 90% success

CS injection- reduction in pain in short term but worse long term- 65% success rate

Question 9

Wrist manipulation on Lateral epicondylalgia

Answer 9

Scaphoid manipulation improved pain and global improvement after 3 weeks

Question 10

prevalence of cervical and thoracic pain with patients with LE

Answer 10

70% vs control group of 16%

Question 11

Joint mobs of lateral glide with ULTT-radial bias with LE

Answer 11

At C5-6
Improved ROM
improved PPT
Improved 24 hour pain
Produces sympathetic excitatory effect

Question 12

Deep friction massage on LE

Acupuncture and LE

Dry needling vs CS injection

Answer 12

No benefit on pain grip or function

SHows short term improvement over placebo but none long term

Dry needling- more effective than CS injection

Question 13

Lateral epincondylalgia- and prognosis

Answer 13

prognosis of 6 months to a year

Question 14

Medial epicondylalgia

Answer 14

Usually involvement of flexors and pronators

Question 15

Differential for Medial epicondylalgia

Answer 15

UCL

Question 16

Tx for medial epicondylalgia

Answer 16

MWM
Wrist strengthening of flexors

Question 17

Distal bicep rupture demographics

Answer 17

Higher risk on smokers and with a use of steroids,

Usually on dominant arm

Question 18

Distal bicep rupture tests and problems with tests

Answer 18

Biceps squeeze test

Hook test

Sensitivity and specifity high however not accurate because pts used had a high suspicion of rupture

Question 19

Distal bicep rupture tx

ANd prognosis after surgery

Answer 19

Younger- surgical

Older- nonsurgical candidates0 manage pain and then strengthening

Prognosis- 1-1.5 years for max recovery benefit