eMedicine Specialties > Sports Medicine > Upper Limb

Medial Epicondylitis: Differential Diagnoses & Workup

Author: Craig C Young, MD, Professor, Departments of Orthopedic Surgery and Community and Family Medicine, Medical Director of Sports Medicine, Sports Medicine Fellowship Director, Medical College of Wisconsin
Contributor Information and Disclosures

Updated: Jan 22, 2008

Differential Diagnoses

Cervical Radiculopathy
Elbow and Forearm Overuse Injuries
Little League Elbow Syndrome
Ulnar Collateral Ligament Injury

Other Problems to Be Considered

Epiphyseal Fracture
Flexor Pronator Strain
Growth Plate (Physeal) Fractures
Osteoarthritis [in the Orthopedic Surgery section]
Osteoarthritis [in the Physical Medicine and Rehabilitation section]
Osteoarthritis [in the Rheumatology section]
Osteochondritis Dissecans (OCD)
Stress Fracture [in the Physical Medicine and Rehabilitation section]
Stress Fracture [in the Radiology section]
Tillaux Fracture
Ulnar Neuropathy

Related Medscape topics:
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CME Curing Cartilage Injuries Part 2: Resurfacing and Restoration in the Knee
CME Current Management Opportunities for Improving Patient Outcomes in Rheumatoid Arthritis
CME Etoricoxib and Naproxen May Have Long-Term Efficacy and Tolerability for OA Treatment
CME Improving NSAID Outcomes: Stratifying Risks and Tailoring Treatment (Slides with Transcript)
Activation of WNT and BMP Signaling in Adult Human Articular Cartilage Following Mechanical Injury
Finger Length Pattern Linked to Osteoarthritis
Interventions for Preventing and Treating Stress Fractures and Stress Reactions of Bone of the Lower Limbs in Young Adults
Shock Wave Therapy Useful for Resistant Stress Fracture in Athletes

Workup

Imaging Studies

  • Plain radiographs may show calcification adjacent to the medial epicondyle in 20-30% of patients with medial epicondylitis, but radiography is not usually needed in the initial workup of this condition.1  However, radiographs should be obtained if there is a history of a traumatic injury, when the physical examination is suspicious for a fracture, and in cases that are recalcitrant to appropriate therapy. Plain radiographs may also be useful in the evaluation for tumors and apophyseal injury.
    • Note: In pediatric patients in whom a diagnosis of medial epicondyle apophysitis, or little leaguer's elbow, is suspected, a radiograph is not only warranted, but also necessary, as the results will help to guide the patient's treatment.
  • Bone scanning is useful for evaluating stress fractures, infection, and tumors.
  • Computed tomography (CT) scanning is useful for evaluating OCD and stress fractures.
  • MRI is useful for evaluating OCD, fractures, and soft-tissue injury. MRI arthrography is useful for evaluating rupture of the UCL.
  • Ultrasonography is contraindicated in children with open growth plates.9

Related Medscape topic:
Resource Center Trauma

More on Medial Epicondylitis

Overview: Medial Epicondylitis
Differential Diagnoses & Workup: Medial Epicondylitis
Treatment & Medication: Medial Epicondylitis
Follow-up: Medial Epicondylitis
References
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References

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Further Reading

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Keywords

golfer's elbow, little leaguer's elbow, overuse tendinopathy

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Contributor Information and Disclosures

Author

Craig C Young, MD, Professor, Departments of Orthopedic Surgery and Community and Family Medicine, Medical Director of Sports Medicine, Sports Medicine Fellowship Director, Medical College of Wisconsin
Craig C Young, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, Phi Beta Kappa, and Wilderness Medical Society
Disclosure: Nothing to disclose.

Medical Editor

Anthony J Saglimbeni, MD, Staff Physician, Family Practice Residency, Medical Director, Center for Sports Medicine, O'Connor Hospital; Private Practice
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

CME Editor

Jon B Whitehurst, MD, Clinical Instructor of Surgery, University of Illinois College of Medicine; Partner and Executive Board Member, Rockford Orthopedic Associates; Orthopedic Chairman, Rockford Memorial Hospital
Jon B Whitehurst, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

Chief Editor

Sherwin SW Ho, MD, Associate Professor, Department of Surgery, Section of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago
Sherwin SW Ho, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

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