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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 PRP/ HA)- ESWT (?)

Step 3 (Rare): (Percutaneous) surgery

Efficacy of non-operative TTM unclear:

(Most often) self -limiting disease


See also Elbow & Common Disorders of the Elbow


PubMed

UpToDate

Images


Video: Exercise


Self Treatment - Schulthess Klinik (German)

ACP/PRP

Article Epicondylopathy with Differential Diagnosis

Lateral Epicondylopathy - Ilchiro

A Review of Current Concepts and Treatment


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