Common extensor tendon thickness measurements at the radiocapitellar region in diagnosis of lateral elbow tendinopathy

Toprak, Uğur; Başkan, Bedriye Mermerci; Üstüner, Evren; Oten, Erol; Altin, Levent; Karademir, Mehmet Alp; Bodur, Hatice

doi:10.4261/1305-3825.dir.5575-12.2

Cited by 19 publications

(25 citation statements)

References 13 publications

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“…Four studies used Colour Doppler Ultrasonography [23,32,35,40] and three studies [33,36,37] used Power Doppler Ultrasonography to detect neovascularity in the common extensor origin. One study used Real-Time Sonoelastrographic scanner to assess for the compressibility of the common extensor origin [22].…”

Section: Resultsmentioning

confidence: 99%

“…During the scanning procedure, elbows were either extended [33] or flexed [22-24,32,34-41] with the forearm either pronated [32,34,35,37,40], supinated [23] or in neutral position [22,23,33,34,38]. Two studies did not report on the position of the elbows during scan [31,42].…”

Section: Resultsmentioning

confidence: 99%

“…The reported mean duration of elbow symptoms in 12 studies was more than 6 weeks [22,24,31,32,34-37,39-42] making Lateral epicondylalgia presentation of a chronic nature. One study [33] did not specifically identify the duration of symptoms but attributed most of their musculoskeletal ultrasound findings to chronicity of Lateral epicondylalgia. Two studies did not indicate their participants’ duration of elbow symptoms [23,38].…”

Section: Resultsmentioning

confidence: 99%

“…In these studies, the patients were recruited from hospitals [32,33,35], local community [34], clinics [37,40], outpatients [31,41], self-referred [37], or referred by health care practitioners [33-40] or were tennis players [42]. The comorbidities and treatment of included patients were variably reported across all included studies.…”

Section: Resultsmentioning

confidence: 99%

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The diagnostic validity of musculoskeletal ultrasound in lateral epicondylalgia: a systematic review

et al. 2014

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BackgroundUltrasound is considered a reliable, widely available, non-invasive and inexpensive imaging technique for assessing soft tissue involvement in Lateral epicondylalgia. Despite the number of diagnostic studies for Lateral Epicondylalgia, there is no consensus in the current literature on the best abnormal ultrasound findings that confirm lateral epicondylalgia.MethodsEligible studies identified by searching electronic databases, scanning reference lists of articles and chapters on ultrasound in reference books, and consultation of experts in sonography. Three reviewers (VCDIII, KP, KW) independently searched the databases using the agreed search strategy, and independently conducted all stages of article selection. Two reviewers (VCDIII, KP) then screened titles and abstracts to remove obvious irrelevance. Potentially relevant full text publications which met the inclusion criteria were reviewed by the primary investigator (VCDIII) and another reviewer (CGS).ResultsAmong the 15 included diagnostic studies in this review, seven were Level II diagnostic accuracy studies for chronic lateral epicondylalgia based on the National Health and Medical Research Council Hierarchy of Evidence. Based from the pooled sensitivity of abnormal ultrasound findings with homogenous results (p > 0.05), the hypoechogenicity of the common extensor origin has the best combination of diagnostic sensitivity and specificity. It is moderately sensitive [Sensitivity: 0.64 (0.56-0.72)] and highly specific [Specificity: 0.82 (0.72-0.90)] in determining elbows with lateral epicondylalgia. Additionally, bone changes on the lateral epicondyle [Sensitivity: 0.56 (0.50-0.62)] were moderately sensitive to chronic LE. Conversely, neovascularity [Specificity: 1.00 (0.97-1.00)], calcifications [Specificity: 0.97 (0.94-0.99)] and cortical irregularities [Specificity: 0.96 (0.88-0.99)] have strong specificity for chronic lateral epicondylalgia. There is insufficient evidence supporting the use of Power Doppler Ultrasonogrophy, Real-time Sonoelastography and sonographic probe-induced tenderness in diagnosing LE.ConclusionsThe use of Gray-scale Ultrasonography is recommended in objectively diagnosing lateral epicondylalgia. The presence of hypoechogenicity and bone changes indicates presence of a stressed common extensor origin-lateral epicondyle complex in elbows with lateral epicondylalgia. In addition to diagnosis, detection of these abnormal ultrasound findings allows localization of pathologies to tendon or bone that would assist in designing an appropriate treatment suited to patient’s condition.

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