US findings for chronic lateral epicondylitis.

Obradov, Marina; Anderson, PG

doi:10.5334/jbr-btr.88

Cited by 7 publications

(22 citation statements)

References 7 publications

(16 reference statements)

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“…Our results for the accuracy of power Doppler MSUS to detect neovascularization (Table 3) are aligned with previous reports for sensitivity (57%-81%) but are noticeably lower than previously reported values for specificity (98%-100%) (12,34). However, estimates of specificity from the two previous studies may have been inflated by the failure to blind the sonographer, which may cause bias in selecting images and interpretation.…”

Section: Discussionsupporting

confidence: 89%

“…Previous studies have reported findings for power Doppler and grayscale MSUS separately (10,26,27) and in combination (12,34). Our results for the accuracy of power Doppler MSUS to detect neovascularization (Table 3) are aligned with previous reports for sensitivity (57%-81%) but are noticeably lower than previously reported values for specificity (98%-100%) (12,34).…”

Section: Discussionsupporting

confidence: 87%

“…Power Doppler MSUS identifies neovascularization, and this has been suggested as an element of the pathophysiological process of tendinopathy and a potential contributor to the pain experience (24,46). Previous reports using a combination of grayscale and power Doppler MSUS to diagnose LE demonstrate a large variation in the sensitivity and specificity, ranging from 72% to 100% and 36% to 100%, respectively (10,12,26,27,34). Most of these studies have failed to include an age-matched control group, and most have not blinded the sonographer to the patient's presentation.…”

mentioning

confidence: 99%

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Diagnostic Ultrasound Imaging for Lateral Epicondylalgia

Heales¹,

Broadhurst²,

Mellor³

et al. 2014

Medicine &Amp; Science in Sports &Amp; Exercise

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 87%

mentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic Ultrasound Imaging for Lateral Epicondylalgia

Heales¹,

Broadhurst²,

Mellor³

et al. 2014

Medicine &Amp; Science in Sports &Amp; Exercise

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“…Separate analysis on studies which added sonographic probe-induced tenderness [24,32], increased blood flow on common extensor origin [40] and those studies which only used provocation tests as part of the reference standard were performed. Studies whose diagnostic sensitivity and specificity cannot be pooled were labeled as not applicable.…”

Section: Resultsmentioning

confidence: 99%

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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“…1 and 2). In cases with tennis elbow, there are typical findings with hypoechogenic areas in the common extensor origin with high blood flow seen on Doppler examination (Obradov and Anderson 2012). The limitation of the ultrasound examination is the experience of the operator.…”

Section: Radiographic Featuresmentioning

confidence: 99%

Lateral and Medial Elbow Tendinopathies

Zeisig

Fahlström

2014

Sports Injuries

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Pain from the lateral and the medial aspect of the elbow is a common symptom in sports, other recreational activities, or work. In tennis elbow, the pain is elicited from the common extensor origin just distal of the lateral epicondyle, while in golfer's elbow, the pain is elicited from the flexorpronator mass just distal to the medial epicondyle. The main symptoms are pain from the epicondyles of the elbow and are related to activity level. The pathogenesis is not known, but these conditions are considered to be overuse injuries of degenerative nature.The diagnoses are verified by clinical examination. Further investigation is not necessary with typical history and clinical findings, and the conditions are self-limiting with good prognosis. In the literature, the golden standard for treatment is conservative treatment although the support in the literature is not conclusive. No treatment has convincing evidence for a faster recovery even though there are, of course, methods for reducing pain symptoms. When the pain is under control, it is important that the return to activity is gradual.

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US findings for chronic lateral epicondylitis.

Cited by 7 publications

References 7 publications

Diagnostic Ultrasound Imaging for Lateral Epicondylalgia

Diagnostic Ultrasound Imaging for Lateral Epicondylalgia

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

Lateral and Medial Elbow Tendinopathies

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