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Physical Examination of the Hand
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
Usually seen in rheumatoid arthritis as a double swelling caused by the common extensor tendon and extensor carpi ulnaris synovitis. Swelling may also be seen on the radio dorsal aspect of the wrist due to extensor carpi radialis tendons and thumb extensors synovitis.
Musculoskeletal system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
The common extensor tendon origin appears as a beak-shaped hyperechoic structure located between the subcutaneous tissue and the lateral ulnar collateral ligament (Fig. 3.15b). The common flexor tendon inserts in the medial epicondyle and appears shorter than the common extensor tendon (Fig. 3.15c). Both tendons have a normal fibrilar pattern. Due to this pattern, it is sometimes difficult to differentiate the lateral ulnar collateral ligament and the extensor tendon.
Regenerative Orthopedics Enabled by Cross-Cutting Technologies
Published in Kohlstadt Ingrid, Cintron Kenneth, Metabolic Therapies in Orthopedics, Second Edition, 2018
PRP has been utilized in the treatment of lateral epicondylitis (LE) with significant beneficial results [18, 4]. In a randomized control trial (RCT), the authors were trying to determine the effectiveness of PRP compared with corticosteroid injections in patients with chronic LE with a 2-year follow-up. One hundred patients with chronic lateral epicondylitis were randomly assigned to a L-PRP injection or the corticosteroid injection using a peppering technique with no activating agents into the common extensor tendon. The study showed statically significant reduced pain (VAS scores) and increased functionality (DASH) in the group treated with L-PRP and no serious complications after a 2-year follow-up.
Prevalence of lateral epicondylosis in veteran manual wheelchair users participating in adaptive sports
Published in The Journal of Spinal Cord Medicine, 2022
Andrea K. Cyr, Berdale S. Colorado, Michael J. Uihlein, Kristin L. Garlanger, Sergey S. Tarima, Kenneth Lee
LE remains a clinical diagnosis, however, ultrasound evaluation of the elbow may reveal calcifications, tears, bony irregularity of the lateral epicondyle and thickening and heterogenicity of the common extensor tendon, all findings suggestive of LE.7,8 Although LE is a clinical diagnosis, ultrasound is being used to confirm this with physical exam findings. For example, a common extensor tendon thickness of 4.2 mm or greater correlates well with LE.9 Previous interobserver studies examining tendon thickness, color doppler activity and bony spurs found good to excellent reliability for all measurements.8,10 Ultrasound findings of hypoechogenicity of the extensor tendon complex and bony changes indicate increased stress of the common extensor tendon at the lateral epicondyle as seen with LE.11 A previous study in the able-bodied population found that the common extensor tendon of the dominant elbow in asymptomatic, able-bodied individuals was thicker as compared to the nondominant elbow in males as compared to females but with no age correlation.12
An evidence-based evaluation of mobile health apps for the management of individuals with lateral elbow tendinopathy using a systematic review framework
Published in Physical Therapy Reviews, 2021
Luke J. Heales, Samantha Randall, Bill Vicenzino, Brooke K. Coombes, Steven Obst
Lateral elbow tendinopathy (LET), or tennis elbow, is a common musculoskeletal condition characterized by pain over the lateral elbow [1]. Despite a relatively simple clinical diagnosis of lateral elbow pain that is provoked by palpation, resisted wrist and finger extension and gripping activities, LET has a multifactorial pathophysiology, including common extensor tendon pathology and sensory and motor system impairments [1]. LET is reported to affect 1-3% of the general population [2], 15% of workers in manual occupations [3], and over 50% of athletes in sports with repetitive overhead arm movements [4]. Evidence suggests that only half of individuals with LET consult a healthcare professional [5], implying that other modes and/or sources of evidence-based health-related information are required.
Ultrasonographic comparison of the lateral epicondyle in wheelchair-user (and able-bodied) tennis players: A pilot study
Published in The Journal of Spinal Cord Medicine, 2021
Vivian Roy, Leah Lee, Michael Uihlein, Ishan Roy, Kenneth Lee
Lateral epicondylosis (LE), previously termed epicondylitis, is a common injury in tennis players and the general population.1 This condition is characterized by degenerative changes in the common extensor tendon due to microtears and scarring from overuse.1 The most commonly affected tendon is that of the extensor carpi radialis brevis (ECRB); however, other extensors such as extensor carpi radialis longus (ECRL) and extensor digitorum communis (EDC) may also be affected.1 The diagnosis is clinical and is often identified as tenderness over the ECRB tendon, 1–2 cm distal and anterior to the lateral epicondyle.1 LE may develop with any prolonged repetitive motion at the wrist, and tennis playing is a known risk factor. According to an epidemiological study of 150 nonprofessional male tennis players, the weekly number of playing hours is the best predictor for LE.2 In this study, the average “pain-free” tennis player spent 5.5 h per week of play time; the average “tennis elbow sufferer” spent 8 h per week.2 In addition, there is evidence that recreational tennis players are more at risk compared to professional players, along with players who use a one-handed backhand as opposed to a two-handed backhand.1,3 Treatment includes rest, occupational therapy (stretching and eccentric strengthening exercises), corticosteroid or platelet-rich plasma injections, and, rarely, surgical intervention such as repair or removal of scar tissue.