Elbow

• Lateral epicondylitis (tennis elbow)

  
  
  

  Lateral epicondylitis (tennis elbow)

  • Causes and diagnosis—Commonly occurs with activities that involve repetitive pronation and supination of the forearm with the elbow in near extension (backhand in tennis). The injury is initiated as a microtear at the origin of the extensor carpi radialis brevis (ECRB) but may also involve the extensor carpi ulnaris (ECU) and the extensor carpi radialis longus (ECRL). Diagnosis is clinical, with reproducible, localized tenderness at the extensor origin and reproduction of symptoms with resisted wrist extension.
  • Treatment is predominantly nonoperative, with activity modification (slower playing surfaces, more flexible racquet, lower string tension, larger grip), physical therapy (stretching, ultrasound), anti-inflammatory medications, counterforce bracing, and up to three corticosteroid injections at the site of maximum tenderness. Recalcitrant cases require open or arthroscopic débridement of the ECRB origin

• Medial epicondylitis (golfer's elbow)

  

  This condition is classified as an overuse syndrome of the flexor/pronator mass. It is much less common and more difficult to treat than tennis elbow. Resisted forearm pronation and wrist flexion worsen the pain. Treatment is similar to that for lateral epicondylitis. Multiple corticosteroid injections should be avoided.

• Elbow Arthroscopy

  

  Indications

  This procedure is typically indicated for diagnostic confirmation of suspected elbow pathology; removal of loose bodies; treatment of osteochondritis dissecans of the capitellum; osteophyte etc Successful arthroscopic intervention depends on technical expertise in elbow arthroscopy and thorough anatomic familiarity because vital neurovascular structures are proximal to the intra-articular space.