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European Radiology

, Volume 28, Issue 3, pp 972–981 | Cite as

Lateral epicondylitis: Associations of MR imaging and clinical assessments with treatment options in patients receiving conservative and arthroscopic managements

  • Ji Young Jeon
  • Min Hee LeeEmail author
  • In-Ho Jeon
  • Hye Won Chung
  • Sang Hoon Lee
  • Myung Jin Shin
Musculoskeletal

Abstract

Objectives

We assessed the implications of MR imaging with clinical history in lateral epicondylitis management by evaluating imaging and clinical features in patients with lateral epicondylitis treated conservatively or operatively.

Methods

Sixty patients with lateral epicondylitis treated conservatively (n = 38) or operatively (n = 22) from 2011–2015 were included. MR imaging findings of common extensor tendon (CET), lateral collateral ligament (LCL) complex, muscle oedema, ulnar nerve and elbow joint were reviewed. Clinical data recorded were frequency, duration and intensity of pain, history of trauma and injection therapy, range of motion.

Results

MRI-assessed CET and LCL complex abnormalities, muscle oedema, radiocapitellar joint widening, joint effusion/synovitis, pain frequency and intensity differed significantly between the two groups (p < .05) with increased severity in operative group. Persistent pain (OR 12.2, p < .01), CET abnormality on longitudinal plane (OR 7.5, p = .03 for grade 2; OR 22.4, p < .01 for grade 3) and muscle oedema (OR 6.7, p = .03) were major factors associated with operative treatment. Area under the ROC curve of predicted probabilities for combination of these factors was 0.83.

Conclusion

MR imaging, combined with clinical assessment, could facilitate appropriate management planning for patients with lateral epicondylitis.

Key Points

MRI can reflect different disease severity between patients treated conservatively/operatively.

CET abnormality, muscle oedema were major MRI findings with operative treatment.

• Patients in operative group were more likely to experience persistent pain.

• MRI plus clinical symptoms could facilitate appropriate management for lateral epicondylitis.

Keywords

Elbow Tennis elbow Magnetic resonance imaging Diagnosis Therapeutics 

Abbreviations

AUC

Area under the curve

CET

Common extensor tendon

ECRB

Extensor carpi radialis brevis

FTT

Full thickness tear

ICC

Intraclass correlation coefficient

LCL

Lateral collateral ligament

MR

Magnetic resonance

PTT

Partial thickness tear

ROM

Range of motion

VAS

Visual analogue scale

Notes

Acknowledgements

The authors would like to thank Dr. Jung Bok Lee, Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea, who helped in conducting the statistical analysis.

Funding

The authors state that this work has not received any funding.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Min Hee Lee, M.D.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

Dr. Jung Bok Lee, Clinical Epidemiology and Biostatistics, kindly provided statistical advice for this study.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• case-control study / observational

• performed at one institution

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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  • Ji Young Jeon
    • 1
    • 2
  • Min Hee Lee
    • 1
    Email author
  • In-Ho Jeon
    • 3
  • Hye Won Chung
    • 1
  • Sang Hoon Lee
    • 1
  • Myung Jin Shin
    • 1
  1. 1.Department of Radiology and Research Institute of RadiologyUniversity of Ulsan College of MedicineSeoulKorea
  2. 2.Department of RadiologyGachon UniversityIncheonKorea
  3. 3.Department of Orthopedic SurgeryUniversity of Ulsan College of MedicineSeoulKorea

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