Abstract
Humeral epicondylopathy (HEP) is a painful ensopathy or tendinitis of the elbow joint that is similar to the tendinopathies observed in the shoulder (rotator cuff syndrome, RCS; see Chap. 14) and the heel (heel spur syndrome, HSS; see Chap. 16). In these disorders usually the tendon insertion zones, sometimes also affecting the neighboring bursae and peritendineum of tendon(s), are involved in a chronic inflammatory process that induces a local and proximally or distally referred pain. Usually this results in impaired joint function with physical consequences for private, professional and sports activities [17, 28, 30]. Besides physical, physiotherapeutic and medical treatments, the use of low-dose radiotherapy (RT) may play an important role affecting the chronic refractory inflammatory process, especially when other treatments have been ineffective.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Similar content being viewed by others
References
Assendelft WJ, Hay EM, Adshead R, Bouter LM (1996) Corticosteroid injections for lateral epicondylitis: a systematic overview. Br J Gen Pract 46:209–216
Baskurt F, Ozcan A, Algun C (2003) Comparison of effects of phonophoresis and iontophoresis of naproxen in the treatment of lateral epicondylitis. Clin Rehabil 17:96–100
Beck W (1975) Zur Ätiologie und Pathogenese der sogenannten “Epicondylitis humeri”. Münch Med Wschr 117:94–96
Burnham R, Gregg R, Healy P, Steadward R (1998) The effectiveness of topical diclofenac for lateral epicondylitis. Clin J Sport Med 8:78–81
Chung B, Wiley JP (2004) Effectiveness of extracorporeal shock wave therapy in the treatment of previously untreated lateral epicondylitis: a randomized controlled trial. Am J Sports Med 32:1660–1667
Ciccotti MC, Schwartz MA, Ciccotti MG (2004) Diagnosis and treatment of medial epicondylitis of the elbow. Clin Sports Med 23:693–705
Comtet JJ, Lalain JJ, Moyen B et al (1985) Epicondylalgia with compression of the posterior branch of the radial nerve. Rev Chir Orthop Reparatrice Appar Mot 71 [Suppl 2]:89–93
Dahmen G, Best S, Siebert W et al (2002) Epicondylopathia radialis humeri. In: Orthopädie. Deutsche Gesellschaft für Orthopädie und orthopädische Chirurgie + Berufsverband der Ärzte für Orthopädie (Hrsg.). Leitlinien der Orthopädie. Vol 2. Auflage. Köln: Dt. Ärzte-Verlag
Goldie I, Rosengreen B, Moberg E, Hedelin E (1970) Evaluation of radiation treatment of painful conditions of locomotor system. Double blind study. Acta Radiol Ther Phys Biol 9:311–322
Haake M, König IR, Decker T et al (2002) Extracorporeal shock wave therapy in the treatment of lateral epicondylitis: a randomized multicenter trial. J Bone Joint Surg Am 84-A:1982–1991
Hannah GA, Whiteside JA (1994) The elbow in athletics. In: Sports medicine secrets. Hanley and Belfus, Philadelphia, pp 249–255
Hildebrandt G, Seed MP, Freemantle CN et al (1998) Mechanisms of the anti-inflammatory activity of low-dose radiation. Int J Radiat Biol 74:367–378
Hildebrandt G, Jahns J, Hindemith M et al (2000) Effects of low dose radiation therapy on adjuvant induced arthritis in rats. Int J Radiat Biol 76:1143–1153
Jansen JTM, Broerse J, Zoetelief J, Klein C, Seegenschmiedt MH (2001) Assessment of carcinogenic risk in the treatment of benign disease of knee and shoulder joint. In: Seegenschmiedt MH, Makoski HB. 15. Kolloquium Radioonkologie/Strahlentherapie, Radiotherapie bei gutartigen Erkrankungen. Diplodocus, Altenberge, pp 13–15
Jobe FW, Nuber G (1986) Throwing injuries of the elbow. Clin Sports Med 5:621–636
Kannus P, Josza L (1991) Histopathological changes preceeding spontaneous rupture of a tendon. J Bone Joint Surg 73A:1507–1525
Keilholz L, Seegenschmiedt MH, Kutzki D, Sauer R (1995) Periarthritis humeroscapularis: Indikation, Technik, Bestrahlungsergebnisse. Strahlenther Onkol 171: 379–384
Keizer SB, Rutten HP, Pilot P et al (2002) Botulinum toxin injection versus surgical treatment for tennis elbow: a randomized pilot study. Clin Orthop Relat Res 401:125–131
Kern PM, Keilholz L, Forster C et al (2000) Low-dose radiotherapy selectively reduces adhesion of peripheral blood mononuclear cells to endothelium in vitro. Radiother Oncol 54:273–282
Kitai E, Itay S, Ruder A et al (1986) An epidemiological study of lateral epicondylitis (tennis elbow) in amateur male players. Ann Chir Main 5:113–121
Kivi P (1984) Rheumatic disorders of the upper limbs associated with repetitive occupational tasks in Finland in 1975-1979. Scand J Rheumatol 13:101–107
Klaiman MD, Shrader JA, Danoff JV et al (1998) Phonophoresis versus ultrasound in the treatment of common musculoskeletal conditions. Med Sci Sports Exerc 30:1349–1355
Kohn HS (1996) Prevention and treatment of elbow injuries in golf. Clin Sports Med 15:65–83
Krämer J (1989) Lehrbuch der Orthopädie, 2. Auflage. Springer, Berlin, Heidelberg, New York
Krahl H (1978) Spezielle Diagnostik und Therapie der Tendinopathie. In:Becker W, Krahl H (eds) Die Tendinopathien. Georg Thieme, Stuttgart, pp 61–89
Kraushaar BS, Nirschl RP (1999) Tendinosis of the elbow (tennis elbow). Clinical features and findings of histological, immunohistochemical, and electron microscopy studies. J Bone Joint Surg Am 81:259–278
Kvist MH, Josza L et al (1987) Chronic Achilles paratenonitis in athletes: A histological and histochemical study. Pathology 19:1–11
Labelle H, Guibert R (1997) Efficacy of diclofenac in lateral epicondylitis of the elbow also treated with immobilization. The University of Montreal Orthopaedic Research Group. Arch Fam Med 6:257–262
Leadbetter B (1992) Cell matrix response in tendon injuries. Clin Sports Med 11:533–578
Leer JWH, van Houtte P, Daelaar J (1998) Indications and treatment schedules for irradiation of benign diseases: a survey. Radiother Oncol 48:249–257
Levitt SH (1995) Secondary malignancies after radiotherapy. In: Dunst J, Sauer R (eds) Late sequelae in oncology. Springer, Berlin Heidelberg New York, pp 279–289
Ljung BO, Forsgren S, Fridén J (1999) Substance P and calcitonin gene-related peptide expression at the extensor carpi radialis brevis muscle origin: implications for the etiology of tennis elbow. J Orthop Res 17:554–559
Mantell BS (1986) The management of benign conditions. In: Hope-Stone HF (ed) Radiotherapy in clinical practice. Butterworths, London, pp 384–399
Manz A, Rausch W (1965) On the pathogenesis and expert evaluation of epicondylitis humeri. Munch Med Wochenschr 107:1406–1413
McCarthy D (1998) Nonsteroidal anti-inflammatory drug-related gastrointestinal toxicity: definitions and epidemiology. Am J Med 105:3S–9S
Mehra A, Zaman T, Jenkin AI (2003) The use of a mobile lithotripter in the treatment of tennis elbow and plantar fasciitis. Surgeon 1:290–292
Melikyan EY, Shahin E, Miles J, Bainbridge LC (2003) Extracorporeal shock-wave treatment for tennis elbow. A randomised double-blind study. J Bone Joint Surg Br 85:852–855
Morrey BF, An KN, Chao EYS (1985) Functional evaluation of the elbow. In: Morrey BF (ed) The elbow and its disorders. Saunders, Philadelphia London Toronto, pp 73–91
Nirschl RP (1988) Prevention and treatment of elbow and shoulder injuries in the tennis player. Clin Sports Med 7:289–308
Nirschl RP (1993) Muscle and tendon trauma: Tennis elbow. In: The elbow and its disorders. Saunders, Philadelphia, pp 481–496
Nirschl RP, Rodin DM, Ochiai DH, Maartmann-Moe C (2003) Iontophoretic administration of dexamethasone sodium phosphate for acute epicondylitis. A randomized, double-blinded, placebo-controlled study. Am J Sports Med 31:189–195
Order S, Donaldson SS (1999) Radiation therapy of benign diseases. Medical radiology, 2nd edn. Springer, Berlin Heidelberg New York
Oskarsson E, Gustafsson BE, Pettersson K et al (2006) Decreased intramuscular blood flow in patients with lateral epicondylitis. Scand J Med Sci Sports 17:211–215
Pfenninger JL (1994) Joint and soft tissue aspiration and injection. In: Procedures for primary care physicians. Mosby, St Louis, pp 1036–1054
Plancher KD, Halbrecht J, Lourie GM (1996) Medial and lateral epicondylitis in the athlete. Clin Sports Med 15:283–305
Plenk HP (1952) Calcifying tendinitis of the shoulder. Radiology 59:384–389
Quillen WS, Magee DJ, Zachazewski JE (1996) The process of athletic injury and rehabilitation. In: Athletic injuries and rehabilitation. WB Saunders, Philadelphia, pp 3–8
Rödel F, Kamprad F, Sauer R, Hildebrandt G (2002) Funktionelle und molekulare Aspekte der anti-inflammatorischen Wirkung niedrig dosierter Radiotherapie. Strahlenther Onkol 178:1–9
Rompe JD, Hope C, Küllmer K et al (1996) Analgesic effect of extracorporeal shock-wave therapy on chronic tennis elbow. J Bone Joint Surg Br 78:233–237
Rubin P, Soni A, Williams JP (1999) The molecular and cellular basis for the radiation treatment of benign proliferative diseases. Sem Radiat Oncol 9:203–214
Seegenschmiedt MH, Stecken A, Keilholz L, Katalinic A (1996) Radiotherapy for refractory painful heel spur: Results of three different dose concepts. Radiology 200:271–276
Seegenschmiedt MH, Keilholz L, Martus P et al (1997) Epicondylopathia humeri (EPH): Indikation, Technik, klinische Ergebnisse der Radiotherapie. Strahlenther Onkol 173:208–218
Seegenschmiedt MH, Katalinic A, Makoski HB et al (2000) Radiation therapy for benign diseases: a patterns of care study in Germany. Int J Radiat Oncol Biol Phys 47:195–202
Shiri R, Viikari-Juntura E, Varonen H et al (2006). Prevalence and determinants of lateral and medial epicondylitis: a population study. Am J Epidemiol 164:1065–1074
Speed CA, Nichols D, Richards C et al (202) Extracorporeal Shockwave therapy for lateral epicondylitis-a double blind randomised controlled trial. J Orthop Res 20:895–898
Stahl S, Kaufman T (1997) The efficacy of an injection of steroids for medial epicondylitis. A prospective study of 60 elbows. J Bone Joint Surg Am 79:1648–1652
Stanley KL, Weaver JE (1998) Pharmacologic management of pain and inflammation in athletes. Clin Sports Med 17:375–392
Thurston AJ (1998) Conservative and surgical treatment of tennis elbow: a study of outcome. Aust N Z J Surg 68:568–572
61.Trott KR (1994) Therapeutic effects of low radiation doses. Strahlenther. Onkol 170:1–12
UNSCEAR (1993) Sources, effects and risks of ionizing radiation, United Nations Scientific Committee on the Effects of Atomic Radiation. United Nations, New York
Valtonen EJ, Lilius HG, Malmio K (1975) The value of roentgen irradiation in the treatment of painful degenerative and inflammatory musculoskeletal conditions. Scand J Rheumatol 4:247–249
Verhaar JA, Walenkamp GH, van Mameren H et al (1996) Local corticosteroid injection versus Cyriax-type physiotherapy for tennis elbow. J Bone Joint Surg Br 78:128–132
Vicenzino B, Brooksbank J, Minto J et al (2003) Initial effects of elbow taping on pain-free grip strength and pressure pain threshold. J Orthop Sports Phys Ther 33:400–407
von Pannewitz G (1933) Die Röntgentherapie der Arthritis deformans. Klinische und experimentelle Untersuchungen. Erg Med Strahlenforsch 6:62–126
von Pannewitz G (1960) Zur Röntgentherapie entzündlicher Krankheiten. Med. Welt X:181–189
von Pannewitz G (1970) Degenerative Erkrankungen. In: Diethelm L, Olsson O, Strnad F, Vieten H, Zuppinger A, eds. Hdb. Med Radiol, Bd. XVII. Springer, Berlin, Heidelberg, New York, pp 73–107
Wang AA, Whitaker E, Hutchinson DT, Coleman DA (2003) Pain levels after injection of corticosteroid to hand and elbow. Am J Orthop 32:383–385
Weh L (1989) Epikondylopathie und Mobilität der Halswirbelsäule. Orthop Praxis 25:126–130
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2008 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Seegenschmiedt, M.H., Guntrum, F., Krahl, H. (2008). Humeral Epicondylopathia (HEP), Lateral and Medial Humeral Epicondylitis. In: Seegenschmiedt, M.H., Makoski, HB., Trott, KR., Brady, L.W. (eds) Radiotherapy for Non-Malignant Disorders. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-68943-0_15
Download citation
DOI: https://doi.org/10.1007/978-3-540-68943-0_15
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-62550-6
Online ISBN: 978-3-540-68943-0
eBook Packages: MedicineMedicine (R0)