Lateral epicondylitis Flashcards Preview

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Flashcards in Lateral epicondylitis Deck (16):
1

Hx

40 yr old carpenter/ motor bike fanatic w/ pain on outside of elbow, pain worst at end of day or after long bike journey, pain radiates down forearm, localises pain just distal to medial epicondyle

2

look/ inspect

nil of note

3

feel

pain on palpation1cm distal to lateral epicondyle

4

active movement

pain on wrist extension

5

passive movement

minimal pain

6

resisted movement

pain exacerbated with resisted wrist extension

7

other exams

neuro exam of hand
c spine exam cervical radiculopathy/ radial nerve impingement

8

DDx

tennis elbow/ lateral epicondylitis
cervical radiculopathy
radial nerve impingement

9

Why is tennis elbow likely?

typical hx of pain annd a career and hobby that involve repetitive wrist extension
exam tenderness distal to lateral epicondyle and pain on resisted wrist extension

10

why is cervical disc disease unlikely?

no pain in c spine
normal neuro exam

11

why is radial nerve impingement unlikely?

normal distal neuro exam with full power of wrist extension

12

investigations?

clinical dx, imaging not required

13

but if imaging is required

xray - if ddx is osteochondral defect/ OA
nerve conduction studies - radial nerve impingement
U/S - dx of partial tendon tear

14

non-op tx

analgesia
watchful waiting - 1 yr
refer to physio
refer to ortho

15

op tx

reserved for refractory cases 6 months of non-op tx
arthroscopic/open debridement of pathological tissue within tendon of ECRB

16

ECRB =

extensor carpi radialis brevis