Tendinopathies Around The Elbow

Fri, 08 May 2026 14:51:42 +0000

The elbow is prone to painful maladaptive degeneration of the tendon attachments. These are typically of insidious onset but precipitating factors may be identified from a careful history.

Lateral epicondylitis
Medial epicondylitis
Distal biceps tendinopathy
Baseball pitcher’s elbow

Lateral Epicondylitis

Also known as tennis elbow
This is the most common tendinopathy
Pain originates from the origin of ECRB (extensor carpi radialis brevis) at the lateral epicondyle
Most cases occur in those with a history of racquet use
Sudden traumatic onset of pain -> tendon rupture -> often requires repair
Usually occurs in active person aged 40-55 years

Clinical features

Lateral elbow pain
- Often after a period of unaccustomed activity
- Radiation down the forearm
- Elbow stiffness in the morning
- Pain is aggravated by lifting objects
ROM - full
Tenderness
- Palpation over the front of the lateral epicondyle
- Maudsley’s test -> resisted middle finger extension
- Mill’s sign -> elbow extension in pronation with a flexed wrist

Diagnosis

Imaging is not required except
- At the extremes of age
- History of trauma
- History of mechanical symptoms e.g. locking
USG / MRI
- In patients with long-standing symptoms, not responding to treatment
- To exclude radial tunnel syndrome, radiocapitellar plica or PLRI (postero-lateral rotator instability)

Treatment

It spontaneously resolves within 12 months in 90% cases.

Elbow on Dr. Asadul Al Galib

Tendinopathies Around The Elbow

Lateral Epicondylitis

Clinical features

Diagnosis

Treatment