- Tendinopathy of the elbow characterized by pain and tenderness at the myotendinous junctions or tendinous insertions of the wrist flexors/extensors at the humeral epicondyles
- Although commonly known as medial and lateral epicondylitis, without microscopic histologic examination, the more appropriate term is medial epicondyle tendinopathy (MET) and lateral epicondyle tendinopathy (LET).
- Most commonly secondary to chronic (overuse) pathology, although acute (traumatic) etiology can occur
- Two types
- MET (“golfer’s elbow”)
- Involves the wrist flexors and pronators, which originate at the medial epicondyle
- LET (“tennis elbow”)
- Involves the wrist extensors and supinators, which originate at the lateral epicondyle
- Most commonly involves the extensor carpi radialis brevis (ERCB) tendon
- MET (“golfer’s elbow”)
- May be caused by various different athletic or occupational activities
- Common in carpenters, plumbers, gardeners, and overhead athletes
- 75% of cases involve the dominant arm.
- Predominant age: >40 years
- Predominant sex: male = female
- Common overuse injury
- Lateral > medial
- Estimated between 1% and 3%
- LET: 1.3%
- MET: 0.4%
Etiology and Pathophysiology
- Acute (tendonitis)
- Rare, uncommon pathology
- Inflammatory response to injury or sudden, violent contraction
- Chronic (tendinosis)
- Overuse injury
- Repetitive wrist flexion or extension places strain across enthesis of flexor/extensor group.
- Degeneration, calcium deposition, fibroblast proliferation, microvascular proliferation, hyaline cartilage destruction, diminished restorative inflammatory response
- Aggravating activities
- Tool/racquet griping
- Shaking hands
- Occupational (painters, mechanics, cooks)
- Sports (golf, tennis, archery, pitchers)
- Repetitive wrist motions
- Flexion/pronation: medial
- Extension/supination: lateral
- Upper extremity forceful activities
- Limit overuse of the wrist flexors, extensors, pronators, and supinators.
- Use proper techniques when working with hand tools or playing racquet sports.
- Use lighter tools and smaller grips.
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Domino, Frank J., et al., editors. "Epicondylitis." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116210/all/Epicondylitis.
Epicondylitis. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116210/all/Epicondylitis. Accessed May 29, 2023.
Epicondylitis. (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116210/all/Epicondylitis
Epicondylitis [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 May 29]. Available from: https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116210/all/Epicondylitis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Epicondylitis ID - 116210 ED - Domino,Frank J, ED - Baldor,Robert A, ED - Golding,Jeremy, ED - Stephens,Mark B, BT - 5-Minute Clinical Consult, Updating UR - https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116210/all/Epicondylitis PB - Wolters Kluwer ET - 27 DB - 5-Minute Clinical Consult DP - Unbound Medicine ER -