Surgery for Medial Epicondylitis (Golfer's Elbow) Workup

Updated: Aug 30, 2022
  • Author: Lacie Alfonso, MD; Chief Editor: Murali Poduval, MBBS, MS, DNB  more...
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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.