Surgery for Medial Epicondylitis (Golfer's Elbow) Workup

Updated: Aug 19, 2020
  • Author: Lacie Alfonso, MD; Chief Editor: Murali Poduval, MBBS, MS, DNB  more...
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Workup

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. [22]

Magnetic resonance imaging (MRI) is sensitive and specific in the evaluation of medial epicondylitis. This modality allows assessment of the tendons, ulnar nerve, and medial collateral ligament. [23]  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. [23, 24]  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. [24]  Real-time sonoelastography has been suggested as a potentially valuable as a supplementary tool in the diagnosis of medial epicondylitis. [25]

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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.

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