EpistemisEpitrochleitis
Specialty: Musculoskeletal.
Why it occurs
- Excessive use of the wrist flexor and pronator teres muscle group
- Repetitive throwing movements
- Work activities with continuous manual forced grip
- Instability of the ulnar collateral ligament of the elbow
- C8-T1 cervical radiculopathy with referred pain
- Ulnar nerve entrapment in the epitrochleocranial tunnel
Initial workup
Musculoskeletal ultrasound of the medial elbow (evaluates the common flexor tendon and the ulnar nerve) | Electromyography (EMG) and nerve conduction velocity if neuropathic symptoms are present | AP and lateral x-ray of the elbow.
red flags
Persistent paresthesias or motor weakness in the fourth and fifth fingers of the affected hand, atrophy of the intrinsic ulnar muscles (indicates severe entrapment of the ulnar nerve requiring surgical decompression).
Standard management
- Ketoprofen gel 2.5% — local topical application every 12 hours
- Etoricoxib — 60 mg once a day orally; long-acting anti-inflammatory
- Ultrasound-guided collagen injection or methylprednisolone infiltration (20 mg in the deep peritendinous plane to avoid skin atrophy).
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