Lateral Epicondyle Tendinopathy Toolkit: Section B - Clinical Assessment: Difference between revisions

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* Abnormal neuro dynamics
* Abnormal neuro dynamics
* Cervical nerve bias
* Cervical nerve bias
* Radial tunnel entrapment of posterior interosseus nerve
* Radial tunnel entrapment of posterior interosseus nerve<ref>The knee resource .Available from https://thekneeresource.com/wp-content/uploads/2018/12/Screendem-P-KIrwan-Spondyloarthropathy.pdf. Accessed on 29th October 2022.</ref>


== Imaging ==
== Imaging ==

Revision as of 10:32, 29 October 2022

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Introduction[edit | edit source]

The purpose of this document is to summarize the clinical assessment of the patient diagnosed with lateral epicondyle tendinopathy.

Initially , the assessment consist of history, objective and subjective examination, chief complains in order to confirm the diagnosis. The tool kit will even include differential diagnosis, the process of identifying causes/risk factors of Achilles tendinopathy and functional examination.

Risk factors[edit | edit source]

Modifiable risk factors

  • Lifestyle
    • Smoking
  • Active individuals/athletic population : Overuse due to repetition of any occupational or recreational activity.
    • Reduced grip strength
    • Improper tennis grip size or poor back hand technique
    • Forceful gripping activity at work
  • Inactive /sedentary lifestyle population : decreased loading capacity of the tendon
  • Reduced rotator cuff weakness on the same side.

Non-modifiable risk factors

  • Age (> 40 years)
  • Gender (F>M)
  • Metabolic disorders like hyperglycemia
  • Cardiovascular risk factors

Assessment[edit | edit source]

Things to look out during the assessment of tennis elbow patient is complete history, subjective examination, objective examination, biopsychological factors and differential diagnosis.

Subjective Assessment[edit | edit source]

  • Subjective symptoms
    • Symptoms increases during activity.
    • Extensor muscles weakness and reduced grip strength
    • Pain is usually localized on the lateral elbow or sometimes referred to extensor or supinator groups of forearm.
  • History
    • Lateral elbow pain which is related to over use.
  • Biopsychological factors
    • It may involve behavioral or psychosocial factors which in turn contributes to neural sensitivity.
    • The evidence states that psychological involvement can increase the symptoms of tennis elbow.
  • Objective Signs
  • Local Examination
    • Palpate the Extensor carpi Radialis Brevis tendon insertion at lateral epicondyle.
  • Special tests :
    • Mills test
    • Maudsley's test
    • Cozen test
    • Thomsen test
Upper quadrant examination Factors of contribution
Cervical Neuropathy, Radiculopathy
Shoulder Weakness of rotator cuff, Neuopathic tender points, Myofascial trigger points
Elbow , Forearm Weak grip strengh, Neuropathic tender points, Myofascial trigger points
Neurodynamics Radial bias

Differential Diagnosis[edit | edit source]

Articular[edit | edit source]

  • Radiocapitular arthritis
  • Intraarticular synovial plica of radial capitular joint
  • Osteochondritis Dessicans[1]

Instability[edit | edit source]

  • Posterolateral rotatory instability because of laxity of collateral ligaments[1]

Neural[edit | edit source]

  • Abnormal neuro dynamics
  • Cervical nerve bias
  • Radial tunnel entrapment of posterior interosseus nerve[2]

Imaging[edit | edit source]

  • It is done only when the conservative management is not working on the patient.
  • Ultrasound and MRI are usually preferred
  • It helps to diagnose the extra and intra articular conditions.[3]

Resources[edit | edit source]

  • bulleted list
  • x

or

  1. numbered list
  2. x

References[edit | edit source]

  1. ↑ 1.0 1.1 British Medical Jpurnal.Available from https://www.jhandtherapy.org/article/S0894-1130(21)00039-9/fulltext.(accessed 29th October 2022)
  2. ↑ The knee resource .Available from https://thekneeresource.com/wp-content/uploads/2018/12/Screendem-P-KIrwan-Spondyloarthropathy.pdf. Accessed on 29th October 2022.
  3. ↑ Karanasios S, Korakakis V, Moutzouri M, Drakonaki E, Koci K, Pantazopoulou V, Tsepis E, Gioftsos G. Diagnostic accuracy of examination tests for lateral elbow tendinopathy (LET)–A systematic review. Journal of Hand Therapy. 2021 Feb 27.
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