Imaging Studies

Standard radiography should be performed to evaluate for other pathology, such as trauma and osteoarthritis. If medial instability is suspected, valgus stress radiographs are recommended.^[23]

Magnetic resonance imaging (MRI) is sensitive and specific in the evaluation of medial epicondylitis (golfer's elbow). This modality allows assessment of the tendons, ulnar nerve, and ulnar (medial) collateral ligament (UCL).^{[24, 25]} However, MRI should be limited to clinically challenging cases.

Ultrasonography (US) may be used to visualize the degenerative tendons that are involved with medial epicondylitis.^{[25, 26]} US has been shown to be sensitive and specific in the diagnosis of medial epicondylitis. In addition, it can help differentiate tendinosis from partial-thickness or intrasubstance tears.^[26]

Real-time sonoelastography has been suggested as a potentially valuable supplementary tool in the diagnosis of medial epicondylitis.^[27] A study by Bang et al found shear-wave elastography to to be comparable to strain elastography for the diagnosis of medial epicondylitis.^[28]

Other Tests

Electromyography (EMG) is indicated in cases where ulnar neuropathy may be associated with this condition.

In an injection test, approximately 1 mL of 2% lidocaine can be injected into the medial epicondyle over the area of maximal tenderness. If the patient has complete relief of pain, then a diagnosis of medial epicondylitis can be made.

Treatment & Management

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Media Gallery

Medial epicondyle.

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Author

Lacie Alfonso, MD Medical Director, The Rehabilitation Center at Dauterive Hospital

Lacie Alfonso, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Stephen Kishner, MD, MHA Clinical Professor, Louisiana State University School of Medicine in New Orleans

Stephen Kishner, MD, MHA is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine

Disclosure: Nothing to disclose.

James Monroe Laborde, MD, MS Clinical Assistant Professor, Department of Orthopedics, Louisiana State University Health Sciences Center and Tulane Medical School; Board of Advisors, Department of Biomedical Engineering, Tulane University; Adjunct Assistant Professor, Department of Physical Medicine and Rehabilitation, Louisiana State University Medical School

James Monroe Laborde, MD, MS is a member of the following medical societies: American Academy of Orthopaedic Surgeons

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Robert J Nowinski, DO Clinical Assistant Professor of Orthopaedic Surgery, Ohio State University College of Medicine and Public Health, Ohio University College of Osteopathic Medicine; Private Practice, Orthopedic and Neurological Consultants, Inc, Columbus, Ohio

Robert J Nowinski, DO is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Medical Association, Ohio State Medical Association, Ohio Osteopathic Association, American College of Osteopathic Surgeons, American Osteopathic Association

Disclosure: Received grant/research funds from Tornier for other; Received honoraria from Tornier for speaking and teaching.

Chief Editor

Murali Poduval, MBBS, MS, DNB Orthopaedic Surgeon, Senior Consultant, and Subject Matter Expert, Tata Consultancy Services, Mumbai, India

Murali Poduval, MBBS, MS, DNB is a member of the following medical societies: Association of Medical Consultants of Mumbai, Bombay Orthopedic Society, Indian Orthopedic Association, Indian Society of Hip and Knee Surgeons

Disclosure: Nothing to disclose.

Additional Contributors

Steven I Rabin, MD, FAAOS Clinical Associate Professor, Department of Orthopedic Surgery and Rehabilitation, Loyola University, Chicago Stritch School of Medicine; Medical Director, Musculoskeletal Services, Dreyer Medical Clinic

Steven I Rabin, MD, FAAOS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Surgeons, American Fracture Association, American Orthopaedic Association, AO Foundation, Chicago Metropolitan Trauma Society, Illinois Association of Orthopaedic Surgeons, Limb Lengthening and Reconstruction Society, Mid-America Orthopaedic Association, Orthopaedic Trauma Association

Disclosure: Nothing to disclose.

Sections Surgery for Medial Epicondylitis (Golfer's Elbow)
Overview
Presentation
Workup
Treatment
References

Surgery for Medial Epicondylitis (Golfer's Elbow) Workup

Imaging Studies

Other Tests

References

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