Evaluation of lateral epicondylopathy, posterior interosseous nerve compression, and plica syndrome as co-existing causes of chronic tennis elbow

Abstract

Purpose A great number of patients that suffer from lateral epicondylitis, commonly called tennis elbow (TE), are not successfully treated, meaning, not getting adequate therapeutic effects and the main origin of the pain not being handled appropriately. The hypothesis of the present study is that the inefficiency of the treatment of the chronic TE may often be due to underdiagnosis of posterior interosseous nerve (PIN) entrapment or and plica syndrome, as the authors believe that those pathologies can often occur simultaneously. Methods A prospective cross sectional study was conducted. A total of 31 patients met the required criteria. Results Thirteen (40.7%) of the patients had more than one source of the lateral elbow pain. Five patients (15.6%) had all three examined pathologies. Six patients (18.8%) had TE and PIN syndrome. Two patients (6.3%) had TE and plica syndrome. Conclusion The present study demonstrated concomitant potential sources of lateral elbow pain in patients diagnosed with chronic TE. Our analysis shows how important it is to systematically diagnose patients that present with lateral elbow pain. The clinical characteristics of the three most common causes of chronic lateral elbow pain, meaning, TE, PIN compression, and plicae syndrome were also analyzed. Having adequate knowledge about the clinical aspects of these pathologies can help with a more effective differentiation of the etiology of chronic lateral elbow pain, and with that, a more efficient and cost-effective treatment plan.

Four Common Upper Body Injuries in Tennis Players: Prevention, Description, and Treatment

“…In rare cases, cervical radiculopathy can sometimes be mistaken for tennis elbow as well as ligamentous instability and posterior interosseous nerve entrapment. 3 These injuries will not resolve with the Protection, Rest, Ice, Compression and Elevation (PRICE) method and won't have the same risk factors as tennis elbow. Patients with symptoms of tennis elbow should keep these injuries in mind, as they may pose a large threat to physical health if they go untreated.…”

Treatment Options for Tennis Elbow — An Umbrella Review

“…Tennis elbow (TE), lateral epicondylitis, or enthesopathy of the extensor carpi radialis origin, is a painful, degenerative condition of the tendon of the extensor carpi radialis brevis (ECRB) near its attachment site to the lateral epicondyle. It is characterized by recurring lateral elbow pain, decreased grip, mobility, and upper-limb strength [1][2][3]. The overall incidence is said to range between 1% to 3% in the general population [4], peaking in the fifth decade without a gender-based difference [5].…”