Abstract
Lateral epicondylitis (LE) is a common disorder of the extensor origin at the lateral humeral epicondyle, first described by Runge in 1873. The annual incidence rate of LE is 1.0 per 100 workers. Clinically, the patient with LE often presents with a painful elbow, defined as pain on the lateral side of the elbow aggravated by direct palpation of the lateral epicondyle and during resisted dorsiflexion of the wrist.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Allen GM, Wilson DJ. Ultrasound in sports medicine-a critical evaluation. Eur J Radiol. 2007;62(1):79–85.
Aspenberg P, Virchenko O. Platelet concentrate injection improves Achilles tendon repair in rats. Acta Orthop Scand. 2004;75(1):93–9.
Benjamin M, Toumi H, Ralphs JR, Bydder G, Best TM, Milz S. Where tendons and ligaments meet bone: attachment sites (‘entheses’) in relation to exercise and/or mechanical load. J Anat. 2006;208(4):471–90.
Borzini P, Mazzucco L. Tissue regeneration and in loco administration of platelet derivatives: clinical outcome, heterogeneous products, and heterogeneity of the effector mechanisms. Transfusion. 2005;45(11):1759–67.
Connell D, Burke F, Coombes P, McNealy S, Freeman D, Pryde D, et al. Sonographic examination of lateral epicondylitis. AJR Am J Roentgenol. 2001;176(3):777–82.
Cyriax J, Troisier O. Hydrocortone and soft-tissue. Br Med J. 1953;2(4843):966–8.
de Mos M, van der Windt AE, Jahr H, van Schie HT, Weinans H, Verhaar JA, et al. Can platelet-rich plasma enhance tendon repair? A cell culture study. Am J Sports Med. 2008;36(6):1171–8.
De ZT, Lill SR, Fink C, Feuchtner GM, Jaschke W, Bellmann-Weiler R, et al. Real-time sonoelastography of lateral epicondylitis: comparison of findings between patients and healthy volunteers. AJR Am J Roentgenol. 2009;193(1):180–5.
duToit C, Stieler M, Saunders R, Bisset L, Vicenzino B. Diagnostic accuracy of power Doppler ultrasound in patients with chronic tennis elbow. Br J Sports Med. 2008;42(11):872–6.
Foster TE, Puskas BL, Mandelbaum BR, Gerhardt MB, Rodeo SA. Platelet-rich plasma: from basic science to clinical applications. Am J Sports Med. 2009;37(11):2259–72.
Fredberg U, Bolvig L. Significance of ultrasonographically detected asymptomatic tendinosis in the patellar and achilles tendons of elite soccer players: a longitudinal study. Am J Sports Med. 2002;30(4):488–91.
Fredberg U, Stengaard-Pedersen K. Chronic tendinopathy tissue pathology, pain mechanisms, and etiology with a special focus on inflammation. Scand J Med Sci Sports. 2008;18(1):3–15.
Fredberg U, Bolvig L, Pfeiffer-Jensen M, Clemmensen D, Jakobsen BW, Stengaard-Pedersen K. Ultrasonography as a tool for diagnosis, guidance of local steroid injection and, together with pressure algometry, monitoring of the treatment of athletes with chronic jumper’s knee and Achilles tendinitis: a randomized, double-blind, placebo-controlled study. Scand J Rheumatol. 2004;33(2):94–101.
Grassi W, Cervini C. Ultrasonography in rheumatology: an evolving technique. Ann Rheum Dis. 1998;57(5):268–71.
Grassi W, Filippucci E, Farina A, Cervini C. Sonographic imaging of tendons. Arthritis Rheum. 2000;43(5):969–76.
Herquelot E, Gueguen A, Roquelaure Y, Bodin J, Serazin C, Ha C, et al. Work-related risk factors for incidence of lateral epicondylitis in a large working population. Scand J Work Environ Health. 2013;39(6):578–88.
Jacobson JA. Ultrasound in sports medicine. Radiol Clin North Am. 2002;40(2):363–86.
Jaen-Diaz JI, Cerezo-Lopez E, Lopez-de CF, Mata-Castrillo M, Barcelo-Galindez JP, De la Fuente J, et al. Sonographic findings for the common extensor tendon of the elbow in the general population. J Ultrasound Med. 2010;29(12):1717–24.
Joshua F, Edmonds J, Lassere M. Power Doppler ultrasound in musculoskeletal disease: a systematic review. Semin Arthritis Rheum. 2006;36(2):99–108.
Khan KM, Cook JL, Kannus P, Maffulli N, Bonar SF. Time to abandon the “tendinitis” myth. BMJ. 2002;324(7338):626–7.
Kraushaar BS, Nirschl RP. Tendinosis of the elbow (tennis elbow). Clinical features and findings of histological, immunohistochemical, and electron microscopy studies. J Bone Joint Surg Am. 1999;81(2):259–78.
Krogh TP, Bartels EM, Ellingsen T, Stengaard-Pedersen K, Buchbinder R, Fredberg U, et al. Comparative effectiveness of injection therapies in lateral epicondylitis: a systematic review and network meta-analysis of randomized controlled trials. Am J Sports Med. 2013;41(6):1435–46.
Krogh TP, Fredberg U, Christensen R, Stengaard-Pedersen K, Ellingsen T. Ultrasonographic assessment of tendon thickness, doppler activity and bony spurs of the elbow in patients with lateral epicondylitis and healthy subjects: a reliability and agreement study. Ultraschall Med. 2013;34:468–74.
Krogh TP, Fredberg U, Stengaard-Pedersen K, Christensen R, Jensen P, Ellingsen T. Treatment of lateral epicondylitis with platelet-rich plasma, glucocorticoid, or saline: a randomized, double-blind, placebo-controlled trial. Am J Sports Med. 2013;41(3):625–35.
Lee MH, Cha JG, Jin W, Kim BS, Park JS, Lee HK, et al. Utility of sonographic measurement of the common tensor tendon in patients with lateral epicondylitis. AJR Am J Roentgenol. 2011;196(6):1363–7.
Levin D, Nazarian LN, Miller TT, O’Kane PL, Feld RI, Parker L, et al. Lateral epicondylitis of the elbow: US findings. Radiology. 2005;237(1):230–4.
Lindenhovius A, Henket M, Gilligan BP, Lozano-Calderon S, Jupiter JB, Ring D. Injection of dexamethasone versus placebo for lateral elbow pain: a prospective, double-blind, randomized clinical trial. J Hand Surg Am. 2008;33(6):909–19.
Ljung BO, Lieber RL, Friden J. Wrist extensor muscle pathology in lateral epicondylitis. J Hand Surg Br. 1999;24(2):177–83.
Maffulli N, Regine R, Carrillo F, Capasso G, Minelli S. Tennis elbow: an ultrasonographic study in tennis players. Br J Sports Med. 1990;24(3):151–5.
Maffulli N, Khan KM, Puddu G. Overuse tendon conditions: time to change a confusing terminology. Arthroscopy. 1998;14(8):840–3.
Maffulli N, Testa V, Capasso G, Ewen SW, Sullo A, Benazzo F, et al. Similar histopathological picture in males with Achilles and patellar tendinopathy. Med Sci Sports Exerc. 2004;36(9):1470–5.
Martinoli C, Bianchi S, Derchi LE. Tendon and nerve sonography. Radiol Clin North Am. 1999;37(4):691–711.
Miller TT, Shapiro MA, Schultz E, Kalish PE. Comparison of sonography and MRI for diagnosing epicondylitis. J Clin Ultrasound. 2002;30(4):193–202.
Molloy T, Wang Y, Murrell G. The roles of growth factors in tendon and ligament healing. Sports Med. 2003;33(5):381–94.
Morris H. THE RIDER’S SPRAIN. Lancet. 1882;120(3074):133–4.
Newcomer KL, Laskowski ER, Idank DM, McLean TJ, Egan KS. Corticosteroid injection in early treatment of lateral epicondylitis. Clin J Sport Med. 2001;11(4):214–22.
Pienimaki T, Tarvainen T, Siira P, Malmivaara A, Vanharanta H. Associations between pain, grip strength, and manual tests in the treatment evaluation of chronic tennis elbow. Clin J Pain. 2002;18(3):164–70.
Poltawski L, Jayaram V, Watson T. Measurement issues in the sonographic assessment of tennis elbow. J Clin Ultrasound. 2010;38(4):196–204.
Poltawski L, Ali S, Jayaram V, Watson T. Reliability of sonographic assessment of tendinopathy in tennis elbow. Skeletal Radiol. 2011;41(1):83–9.
Pomerance J. Radiographic analysis of lateral epicondylitis. J Shoulder Elbow Surg. 2002;11(2):156–7.
Rees JD, Maffulli N, Cook J. Management of tendinopathy. Am J Sports Med. 2009;37(9):1855–67.
Regan W, Grondin P, Morrey BF. Lateral epicondylitis (tennis elbow). In: DeLee J, Drez D, Miller M, editors. DeLee and Drez’s orthopaedic sports medicine. 3rd ed. Elsevier; 2009. p. 1197–204.
Runge F. Zur Genese und Behandlung des Schreibekrampfes. Berliner Klinische Wochenschrift. 1873;10:245–8.
Sampson S, Gerhardt M, Mandelbaum B. Platelet rich plasma injection grafts for musculoskeletal injuries: a review. Curr Rev Musculoskelet Med. 2008;1(3–4):165–74.
Smidt N, Van Der Windt DAWM, Assendelft WJJ, Deville WLJM, Korthals-De Bos IBC, Bouter LM. Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis: a randomised controlled trial. The Lancet. 2002;359(9307):657–62.
Struijs PA, Spruyt M, Assendelft WJ, van Dijk CN. The predictive value of diagnostic sonography for the effectiveness of conservative treatment of tennis elbow. AJR Am J Roentgenol. 2005;185(5):1113–8.
Torp-Pedersen T, Torp-Pedersen S, Bliddal H. Diagnostic value of ultrasonography in epicondylitis. Ann Intern Med. 2002;136(10):781–2.
Wakefield RJ, Balint PV, Szkudlarek M, Filippucci E, Backhaus M, D’Agostino MA, et al. Musculoskeletal ultrasound including definitions for ultrasonographic pathology. J Rheumatol. 2005;32(12):2485–7.
Zeisig E, Ohberg L, Alfredson H. Extensor origin vascularity related to pain in patients with Tennis elbow. Knee surgery sports traumatology. Arthroscopy. 2006;14(7):659–63.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer Science+Business Media New York
About this chapter
Cite this chapter
Krogh, T., Fredberg, U., Ellingsen, T. (2015). Chronic Lateral Epicondylitis—New Perspectives on Injection Strategies and Ultrasound Evaluation. In: Wolf, J. (eds) Tennis Elbow. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7534-8_4
Download citation
DOI: https://doi.org/10.1007/978-1-4899-7534-8_4
Published:
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4899-7533-1
Online ISBN: 978-1-4899-7534-8
eBook Packages: MedicineMedicine (R0)