Epicondylopathy
Epicondylopathy (also previously misleadingly "epicondylitis") is a painful irritation of tendon insertions of the forearm muscles. There are two types of epicondylopathy:
Type | Common Name | Relative Frequency | Affected Muscles |
Lateral Epicondylopathy | Tennis elbow | More frequent | Extensors |
Medial Epicondylopathy | Golfer’s elbow | Less frequent | Flexors |
We recommend not to use the term "tennis elbow" anymore. In 1896 Bernhardt M. described an "occupational neuralgia", Osgood R.B. published a case series of "tennis elbow" with different underlying pathologies in 1922 and the term was mistakenly adopted as a general term for lateral elbow pain. Furthermore, the term "tennis elbow" is a misnomer: Only 10-50 % of all adult tennis players develop complaints of the elbow depending on the duration and frequency of the game and only 10 % of those affected play tennis! The term "epicondylitis" should also no longer be used; it implies a primary inflammation, which is rarely present. Histologically there is no inflammation, but angio-fibroblastic tendon hyperplasia does exist.A combination of anamnesis, status and specific imaging is needed to make a specific diagnosis. In clinical routine we most frequently see lesions of ECRB with and without accompanying lesion of the EDC / ECU due to mechanical overload with repetitive use of supinators, wrist and finger extensors.
There are a wide variety of conservative treatment options available, such as cooling, immobilization, ultrasound, prp injection, hyaluronic acid injection, laser therapy, etc. Surgical treatment is usually not necessary, but is also an option.
3 TTM Steps
Step 1: Activity modification-eccentric excercises- bracing
Step 2: Injections (1x ACP/ Hyaluronic Acid)- ESWT (?)
Step 3 (Rare): (Percutaneous) surgery
Article Epicondylopathy with Differential Diagnosis
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