Laboratory Studies
See the list below:
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Laboratory studies are generally not indicated in ME.
Imaging Studies
See the list below:
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A radiograph of the elbow is often performed to rule out associated lesions (eg, loose bodies, bony avulsion, osteoarthritis). Typically, anteroposterior and lateral films are adequate.
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Oblique views are needed if loose bodies are suggested upon examination or because of a catching or clicking sensation described by the patient.
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Valgus stress radiographs should be obtained if medial instability is suggested.
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Magnetic resonance imaging (MRI) may be helpful in looking for the characteristic pathology that is seen in chronic cases of ME; MRI also permits assessment of the medial collateral ligament and ulnar nerve. [3] Although in most cases an MRI scan is not necessary, it should be considered in individuals with atypical symptoms or in patients who are not responsive to conservative measures.
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Research suggests that ultrasonography also is useful for the diagnosis of ME. In a prospective, single-blind study, Park et al found that ultrasonographic findings were positive in 20 of 21 elbows with ME and were negative in 23 of 25 elbows without ME. [9] According to the investigators, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of ultrasonography in the diagnosis of clinical ME were, respectively, 95.2%, 92%, 93.5%, 90.9%, and 95.8%. They therefore recommended that ultrasonography be considered as an initial imaging modality in the evaluation of ME.
Other Tests
See the list below:
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If ulnar nerve involvement is suggested, a nerve conduction study and electromyography should be performed.
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Medial epicondyle.
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Strengthening exercises are performed once pain has subsided with active range of motion. The starting position (slight pronation) of an eccentric exercise for medial epicondylitis is shown. In order to prevent further injury, a trained therapist should instruct patients in exercises to confirm proper weight and technique.
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The eccentric exercise proceeds until full supination has been reached.
