Physical examination of the elbow, what is the evidence? A systematic literature review

Zwerus, Elisa L.; Somford, Matthijs P.; Maissan, François; Heisen, Jelle; Eygendaal, Denise; Bekerom, Michel P.J. van den

doi:10.1136/bjsports-2016-096712

Cited by 57 publications

(27 citation statements)

References 39 publications

(35 reference statements)

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“…Resistance of wrist extensors with full elbow extension and pronation can reproduce the pain in mild-tomoderate cases [25]. Special tests are commonly used during the physical examination, such as the chair test, Cozen's test, and Mill's test [32,33]. Chair test requires the patient to lift a chair with the shoulder adducted, elbows extended, and forearms pronated.…”

Section: Diagnosismentioning

confidence: 99%

Management of Lateral Epicondylitis: A Narrative Literature Review

Wang

2020

Pain Research and Management

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Lateral epicondylitis, also termed as “tennis elbow,” is the most common cause of elbow pain and dysfunction, mainly resulting from repetitive gripping or wrist extension during various activities. The exact pathogenesis remains largely elusive with putative tendinosis, a symptomatic degenerative process of the local tendon. It is usually diagnosed by clinical examinations. Sometimes, additional imaging is required for a specific differential diagnosis. Although most cases can be self-healing, the optimal treatment strategy for chronic lateral epicondylitis remains controversial. This article presents a landscape of emerging evidence on lateral epicondylitis and focuses on the pathogenesis, diagnosis, and management, shedding light on the understandings and treatment for healthcare professionals.

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Section: Diagnosismentioning

confidence: 99%

Management of Lateral Epicondylitis: A Narrative Literature Review

Wang

2020

Pain Research and Management

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“…Cozen's, Maudsley's, Mill's, and grip strength tests may assist in diagnosis (Box 1). 3,5,7 An important differential diagnosis to consider is osteoarthritis of the radiocapitellar joint, where pain on palpation of the joint line with reduced range of elbow pronation and supination are predominant features. Range of motion is not affected in LET.…”

Section: Diagnosismentioning

confidence: 99%

Lateral elbow tendinosis: a review of diagnosis and management in general practice

Speers¹,

Bhogal²,

Collins³

2018

Br J Gen Pract

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“…The diagnosis of lateral epicondylitis (LE) is clinical. Painful palpation of the lateral epicondyle is suggestive of the condition, and speci c tests such as the Cozen test and Mill's test can be used, despite the lack of an accuracy study in this regard [26]. The change in grip strength, measured with a dynamometer, with the wrist in exion and extension, indicates the diagnosis, as normal individuals do not present a difference.…”

Section: Discussionmentioning

confidence: 99%

How One Treats Lateral Epicondylitis - A Survey Among Brazilian Orthopedists

Lazarini

Zan

Belotti

et al. 2021

Preprint

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Background: Lateral epicondylitis (LE) or tennis elbow is the most common elbow painful condition. It affects around 1 to 3% of adults. There are various possibilities of treatment described in the literature, without evidence to support a gold standard management protocol. Therefore, the objective of this study is to evaluate how the Brazilian orthopedist diagnoses and treats lateral epicondylitis, to compare these results with the available evidence. Methods: This is an observational, analytical, cross-sectional study. A questionnaire has been prepared for information to the participants and with eight specific questions (2 on diagnosis and 6 on treatment). These had been answered voluntarily by participants at 3 major congresses of orthopedists in Brazil in 2018. The results were analyzed in accordance with the overall number of responses, and were evaluated among groups according to subspecialty. Results: We obtained a total of 501 questionnaires. Of these, 33 were excluded. The mean age was 38.67 years. The majority of respondents (91%) were male. We obtained 26.7% from specialists in hand surgery (Hand group), 36.5% from subspecialists in shoulder and elbow (Shoulder and Elbow group), and 36.8% were from generalists in orthopedics or from other subspecialties (General Orthopedists group). For diagnosis, 24.4% have not initially requested any imaging method. The most requested exam was ultrasonography (54.9%). The most prominent indication for initial treatment was physical therapy. For refractory cases, 78.3% of the respondents prefer doing a local infiltration. The most commonly used substance for local infiltrations is corticosteroids (89.6%). With respect to the surgical treatment option, 75.8% of those who recommend it prefer open techniques and 24.2% arthroscopic treatment. Of the total respondents, 12.8% do not recommend surgical treatment for LE. Conclusion: Most orthopedists begin the treatment of lateral epicondylitis with the use of non-steroidal anti-inflammatory drugs, physical therapy, and an indication of rest, but there is great variability between their recommendations. The use of corticosteroids for infiltration remains the main choice among Brazilian orthopedists, although evidence shows a better effect in the short term and a worse effect in the medium and long term, compared to other treatments.

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Physical examination of the elbow, what is the evidence? A systematic literature review

Abstract: Numerous clinical tests for the elbow were described in literature, seldom accompanied with data on diagnostic accuracy. None of the described tests can provide adequate certainty to rule in or rule out a disease based on sufficient diagnostic accuracy.

Cited by 57 publications

References 39 publications

Management of Lateral Epicondylitis: A Narrative Literature Review

Management of Lateral Epicondylitis: A Narrative Literature Review

Lateral elbow tendinosis: a review of diagnosis and management in general practice

How One Treats Lateral Epicondylitis - A Survey Among Brazilian Orthopedists

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