Ultra sonographic findings for chronic lateral epicondylitis

Area of Science:

• Musculoskeletal imaging
• Diagnostic ultrasonography
• Orthopedic diagnostics

Background:

• Lateral epicondylitis, commonly known as tennis elbow, is a frequent cause of elbow pain.
• Accurate diagnosis is crucial for effective treatment and management.
• Ultrasound (US) is a valuable tool for evaluating musculoskeletal conditions.

Purpose of the Study:

• To identify specific gray-scale and color Doppler US findings associated with lateral epicondylitis.
• To determine the diagnostic performance of individual and combined US findings.
• To investigate the possibility of chronic lateral epicondylitis without positive US findings.

Main Methods:

• Retrospective analysis of gray-scale US imaging in 49 patients with lateral epicondylitis.
• Inclusion of 5 asymptomatic volunteers as controls.
• Assessment of specific US findings including external contour, cortical erosion, calcifications, tears, and neovascularity.

Main Results:

• Individual gray-scale findings (convex contour, erosive cortex, calcifications, tear) and neovascularity showed 100% specificity.
• Neovascularity by color Doppler had a sensitivity above 50%.
• Combined gray-scale and color Doppler US achieved 92-100% sensitivity, 90% specificity, and 98% positive predictive value.

Conclusions:

• The combination of gray-scale and color Doppler US is diagnostically superior for chronic lateral epicondylitis.
• Key diagnostic signs include convex boundary, erosive cortex, calcifications, tear, and neovascularity.
• Patients with clinical signs but no US findings may require further MRI evaluation.