EpistemisLateral epicondylitis
Specialty: Musculoskeletal.
Why it occurs
- Repetitive overload of the extensor carpi radialis brevis tendon (due to pronosupination or wrist extension movements)
- Direct trauma to the lateral region of the elbow
- Inappropriate sports practice (tennis, paddle tennis)
- Lifting loads with poor ergonomics
- Non-inflammatory age-related tendon degeneration (tendinosis)
- Referred C6 cervical radiculopathy
Initial workup
High resolution elbow ultrasound (shows tendon thickening, microtears and neovascularization with Doppler) | Simple x-ray of AP and lateral elbow (to rule out intratendinous calcifications or osteophytes) | Elbow MRI if symptoms persist after conservative therapy.
red flags
Sudden loss of hand grip strength associated with numbness in the territory of the radial nerve, severe swelling or erythema in the elbow (complete tear of the extensor tendon or subepicondylar septic bursitis).
Standard management
- Diclofenac diethylammonium gel 1.16% — apply topically every 8 hours with a gentle massage on the epicondyle
- Celecoxib — 200 mg once daily orally; selective COX-2 inhibitor for relief of the acute painful phase
- Local injection of platelet-rich plasma (PRP) or infiltration with depot corticosteroids in the tendon insertion (under ultrasound guidance).
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Musculoskeletal
- Listed causes
- 6
- Treatment options
- 3