The purpose of this study was to investigate the treatment response in lateral epicondylitis (tennis elbow) by MRI. Magnetic resonance imaging was obtained in 30 patients with clinical symptoms of lateral epicondylitis of the elbow using T1-, T2- and T2-weighted fat-saturated (FS) sequences. The patients were randomised to either i.m. corticosteroid injection ( n=16) or immobilisation in a wrist splint ( n=14). Magnetic resonance imaging of the elbow was performed on a 1.5-T MR system at baseline and after 6 weeks. The extensor carpi radialis (ECRB) tendon, the radial collateral ligament, lateral humerus epicondyle at tendon insertion site, joint fluid and signal intensity changes within brachio-radialis and anconeus muscles were evaluated on the MR unit's workstation before and after 6 weeks of treatment. The MRI was performed once in 22 healthy controls for comparison and all images evaluated by an investigator blinded to the clinical status of the subjects. The MR images showed thickening with separation of the ECRB tendon from the radial collateral ligament and abnormal signal change in 25 of the 30 patients on the T1-weighted sequences at inclusion. The signal intensity of the ECRB tendon was increased in 24 of the 30 patients with lateral epicondylitis of the elbow on the T2-weighted FS sequences. In the patients there were no associations between pathologically signal intensity within the ECRB tendon on T1- and T2-weighted sequences and the degree of self-reported pain (Dumbells test) at inclusion. In general, the MRI changes persisted in the patients at follow-up after 6 weeks despite clinical remission. The increased signal intensity within the extensor tendon is indicative of lateral epicondylitis humeri. The changes in signal intensity and morphology of ECRB tendon seem to be chronic and may persist despite clinical improvement.
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http://dx.doi.org/10.1007/s00330-003-2165-4 | DOI Listing |
Hand Surg Rehabil
December 2024
Department of Orthopedic Surgery, CHU Nimes, Avenue du Professeur Debré, 30000 Nimes, France.
Lateral epicondylitis is a very common form of tendinosis that may heal spontaneously. Diagnosis is mainly clinical. Treatment is usually non-operative.
View Article and Find Full Text PDFInt J Surg
December 2024
Department of Rehabilitation, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Arthrosc Tech
November 2024
Department of Sports Medicine, Beijing Jishuitan Hospital Affiliated to Capital Medical University, Beijing, China.
Lateral epicondylitis, or tennis elbow, has been attributed to the degeneration of the extensor carpi radialis brevis tendon, with surgery reserved for recalcitrant cases. Surgical intervention of lateral epicondylitis includes release alone or release with repair. Outcomes of open surgical repair have been reported with better preservation of the grip strength than release alone.
View Article and Find Full Text PDFMedicine (Baltimore)
December 2024
Department of Orthopedic Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Rationale: Lateral epicondylitis, commonly known as tennis elbow, is a chronic condition characterized by tendinosis at the insertion site of the lateral epicondyle. Various treatment methods are available, ranging from conservative to surgical options for refractory lateral epicondylitis. Recently, platelet-rich plasma (PRP) injections have shown effectiveness for treating this condition.
View Article and Find Full Text PDFJ Orthop Surg Res
December 2024
Department of Orthopedics, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang Province, 315000, China.
Background: Tendinopathy is very common in clinical practice, which is highly prevalent in athletes, sports enthusiasts and other people involved in high-load weight-bearing activities. Common types of tendinopathy include rotator cuff injury, Achilles tendinitis, tennis elbow and so on. Macrophages (Macs) are key immune cells in the pathogenesis of tendinopathy.
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