Lateral Elbow Tendinopathy (Tennis Elbow)
Conditions
Keywords
Elbow pain, Lateral epicondylitis, Cozen, Elastography
Brief summary
Lateral elbow tendinopathy (LET) is the most common cause of elbow pain. Even though provocation tests such as Cozen's test, Mill's test or Maudsley test; musculoskeletal ultrasound or magnetic resonance imaging can be used for diagnosis, gold standard method is yet to be determined. Purpose of this study is to determine the sensitivity and specificity of clinical tests and ultrasonography in diagnosis of LET.
Interventions
None listed
Sponsors
Marmara University
Study design
Observational model
CASE_CONTROL
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
* Patients aged 18-60 with unilateral elbow pain * Tenderness with palpation at the lateral epicondyle * Pain triggered with pressure compared to the opposite lateral epicondyle with algometer.
Exclusion criteria
* History of rheumatologic diseases * History of e corticosteroid injections on lateral epicondyle * History of elbow surgery or infection
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Elastography | At enrollment | Both shear wave and strain elastography will be applied. Stiffness and shear wave velocity will be calculated on shear wave elastography and strain ratio will be calculated on strain elastography. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hand Grip Strength | At enrollment | Both painless and maximum grip strength will be examined using Jamar's hand dynamometer. |
| Algometer | At enrollment | Force will be applied to lateral epicondyle using an algometer. |
| Musculoskeletal ultrasound | At enrollment | Sonographic evaluation will begin with gray scale examination. Swelling, cortical irregularity, hypoechogenicity, calcification, tear common extensor tendon thickness will be assessed. Power doppler will be evaluated between the superficial fibers of the common extensor tendon, the bone surface, the insertion point of the common extensor tendon and the humeroradial joint. Doppler activity will be graded based in a 0.5-cm longitudinal part of the tendon with the maximal Doppler activity (the region of interest-ROI). The 5-point grading will be as follows. Grade 0: No activity, Grade 1: Single vessel, Grade 2: Doppler activity in 0-25% of the ROI, Grade 3: Doppler activity in 25-50% of the ROI, Grade 4: Doppler activity in \>50 of ROI. Lastly elastography will be used. |
| Patient Rated Tennis Elbow Evaluation | At enrollment | Patient Rated Tennis Elbow Evaluation will be used to assess pain and functional status in patients diagnosed with LET. |
| Maudsley's Test | At enrollment | Resisted third finger extension will be performed while patient is sitting and elbow on 90 degrees flexion. Maudsley's test will be applied to both extremities. Pain felt on the lateral epicondyle during provocation indicates a positive test result. |
| Mill's test | At enrollment | Maximal wrist flexion will be performed while patient is sitting, elbow on extension and forearm pronation. Mill's test will be applied to both extremities. Pain felt on the lateral epicondyle during provocation indicates a positive test result. |
| Cozen's test | At enrollment | Resisted wrist extension will be performed while patient is sitting and elbow on extension. Cozen's test will be applied to both extremities. Pain felt on the lateral epicondyle during provocation indicates a positive test result. |
Countries
Turkey (Türkiye)
Contacts
Primary ContactArda Can Kasap, M.D.
Outcome results
None listed