MR findings in humeral epicondylitis. . A systematic review

Abstract

Small sample size and methodological shortcomings in the original studies make the assessment of MR findings in epicondylitis questionable. There is a need for well-designed studies in which clinical features and occupational backgrounds as well as imaging parameters are carefully documented.

The Reliability and Validity of Magnetic Resonance Imaging in the Assessment of Chronic Lateral Epicondylitis

“…11 Savnik et al commented that, within their patient group, there was no difference in pain level in patients with and without abnormal signal intensity but did not comment on any other functional deficits. 12 We have confirmed in this study, in accordance with previous studies 5,11,12 and the meta-analysis, 14 that the majority of patients with a clinical diagnosis of chronic lateral epicondylitis have signal changes on MRI. We have further established that the severity of these changes can be reliably interpreted by different radiologists and at multiple reviews.…”

“…5,11,12 This is confirmed by a meta-analysis showing that MRI signal change occurred in 90% of elbows with lateral epicondylitis compared to only 14% of controls, although 50% of the contralateral elbows in the affected subjects also demonstrated MRI signal change. 14 The series by Potter et al and Steinborn et al found high levels of correlation between MRI assessment and both surgical and histopathological findings. 2,15 A study by van Kollenberg et al demonstrated that patients with a clinical diagnosis of lateral epicondylitis were significantly more likely to have signal changes on MRI (p Ͻ .001).…”

Repetitive strain injury

“…49 They advise that MRI can provide important diagnostic information for assessment of lateral epicondylitis, but that ultrasonography is of little diagnostic value. However, a systematic review concluded 50 that the assessment of MRI fi ndings in epicondylitis was questionable because the diagnostic studies included were of low quality. Additionally, MRI is associated with high costs, and these images are unlikely to aff ect treatment decisions or outcomes.…”

Magnetic resonance imaging findings of refractory tennis elbows and their relationship to surgical treatment

“…A recent metaanalysis of diagnostic MRI of lateral epicondylitis of the elbow in 148 patients in 7 studies demonstrated a signal change of the common extensor origin in 90% of elbows whereas the signal change was observed in only 14% of elbows in healthy volunteers. 13 Another MRI study of 9 cases of severe lateral epicondylitis demonstrated 1 patient with a thickened collateral ligament, 3 patients with partial tears of the ligament, and 5 patients with a complete tear. 2 Steinborn et al 16 reported on the use of MRI of lateral epicondylitis of the elbow in 23 patients.…”