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Examination of Pediatric Elbow
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Karthick Rangasamy, Nirmal Raj Gopinathan, Pebam Sudesh
The lateral epicondyle is the most prominent bony point on the lateral aspect of the distal humerus, and it is palpated by flexing the elbow to 90°. The lateral supracondylar ridge will be traced downwards, and the most prominent bony landmark beneath, which is the bone, starts receding and will be marked as the lateral epicondyle. Tenderness over this area may be due to lateral epicondylitis/apophysitis, depending on the age of the child or fracture of the lateral condyle or supracondylar humerus.
Upper Limb
Published in Harold Ellis, Adrian Kendal Dixon, Bari M. Logan, David J. Bowden, Human Sectional Anatomy, 2017
Harold Ellis, Adrian Kendal Dixon, Bari M. Logan, David J. Bowden
The epicondyles have developed to provide attachment of the common extensor (lateral epicondyle) and flexor (medial epicondyle) muscle groups. Inflammation of the extensor origin on the lateral epicondyle (22) is known as ‘tennis elbow’. This section provides an excellent view of the superior radio-ulnar joint between the head of the radius (11) and the radial notch of the ulna (18). It communicates freely with the elbow joint. Together with the inferior radio-ulnar joint, it allows the movements of pronation and supination of the forearm, which are unique to the primate upper limb.
Practice Paper 2: Answers
Published in Anthony B. Starr, Hiruni Jayasena, David Capewell, Saran Shantikumar, Get ahead! Medicine, 2016
Anthony B. Starr, Hiruni Jayasena, David Capewell
Tennis elbow is inflammation at the insertion of the tendon into the lateral epicondyle of the elbow. This often occurs in response to repetitive strain of the tendon. There is pain over the lateral epicondyle that radiates down the forearm and is exacerbated by wrist extension. Management options are rest, NSAIDs and steroid injection. Severe cases are treated by surgery, where the tendon of the forearm extensors is stripped from the lateral epicondyle and replaced. Golfer’s elbow describes a similar condition but on the medial epicondyle, with pain that is worse on wrist flexion.
The utilization and effects of filiform dry needling in the management of tendinopathy: a systematic review
Published in Physiotherapy Theory and Practice, 2022
Dhinu J. Jayaseelan, Brian T. Faller, Melinda H. Avery
Filiform DN was used in isolation in 3/10 studies in this review. One case report reported a single session of needle insertion and static placement for medial elbow tendinopathy. Pain and ROM were reported to improve immediately and at a 2-day follow-up but no objective data were reported (Shariat et al., 2018). In an RCT, static needling near the lateral epicondyle was compared to non-steroidal anti-inflammatory medication and forearm bracing for individuals with lateral elbow tendinopathy. While both groups showed improvement, the DN group had greater improvement at all time points, including a 6 month follow up (p < .01) (Uygur et al., 2017). Another RCT used DN in isolation compared to low-level laser therapy (LLLT) for lateral elbow tendinopathy. Both the DN and LLLT groups improved significantly, but no between-group differences were noted and no follow-up was performed (Shanmugam, Mathias, and Rai, 2015). When used in isolation, DN may have an immediate and medium-term benefit in reducing pain and improving function, but may not be more effective than other passive interventions.
Efficacy of physical therapy interventions for chronic lateral elbow tendinopathy: a systematic review
Published in Physical Therapy Reviews, 2020
Beshoy Girgis, José Alberto Duarte
Many theories regarding the etiology of LET have been mentioned in the literature [31–35], but it has been historically considered an overuse strain of the origin of wrist extensors [36,37]. It is thought to result from degeneration of the tendons of wrist extensor muscles, primarily the extensor carpi radialis brevis, at their proximal attachment at the lateral epicondyle, which is commonly described as tendinosis [38–40]. However, the pathological cascade of tendinopathy seems to include inflammation and degeneration [33,41]. Indeed, recent systematic reviews [42,43] and narrative reviews [32,44] have supported the role of inflammation in the pathogenesis of tendinopathy. Furthermore, other studies have also indicated that inflammation can promote the development of overuse tendon injury [45–52]. This concept of the involvement of an inflammatory component in tendinopathy is also supported by the animal models’ findings, which have demonstrated accumulation of inflammatory cells and cytokines [48,53–56].
Segmental and extrasegmental hypoalgesic effects of low-frequency pulsed current and modulated kilohertz-frequency currents in healthy subjects: randomized clinical trial
Published in Physiotherapy Theory and Practice, 2021
Érika Patrícia Rampazo da Silva, Viviane Ribeiro Silva, Anabelly Sato Bernardes, Fábio Matuzawa, Richard Eloin Liebano
The first area of measurement of the PPT was marked on the dominant forearm (i.e. forearm extensor muscle). It was considered the segmental area because in this area, the electrical stimulation was applied. For this, a straight line was drawn between the lateral epicondyle of the elbow and the midpoint between the medial and lateral border of the wrist. The first electrode was positioned on the forearm at the elbow fold next to the lateral epicondyle and the second electrode was positioned 3 cm from the end of the first electrode on the previously drawn straight line (Figure 1). The measuring point of the algometer was exactly midway between the two electrodes (Chen and Johnson, 2009, 2010).