[Differential diagnosis of epicondylitis humeri radialis]

Intensive amateur sport will lead especially in the untrained to frequent traumatisation. Exact discussion of the symptomatics of the epicondylitis seems to be necessary. Sufficient therapy of various pain symptoms, which are usually described as epicondylitis is only possible after exact differentiation. Paraarticular pain can be caused by the ligamentum-anulare-syndrome as well as by the classic insertion tendinosis. A hypertrophy of the radio-humeral disc can also be the reason of pain after posttraumatic synovitis. Osteoarthritis and rheumatoid arthritis can easily be differentiated from posttraumatic changes by anamnesis and clinical examination. In a large group of patients pain in the elbow region is caused by cervical spine disturbancies, which are frequently overlooked. Similar symptoms can be seen in cases with peripheral irritation of the radial nerve, which can be entrapped as in the supinator syndrome. Juvenile patients can also suffer from osteonecrosis (M. Panner, M. Hegemann) or from epiphysiolysis. In the years from 1975 to 1980 1,096 patients with pain symptoms at the radial epicondyle of the humerus were treated at the Orthopedic Clinic of the University of Vienna under exclusion of those cases with cervical spine disturbancies. Out of the 1,096 patients seen 60 were treated surgically (5,47%) because of insertion tendinosis. 35 cases of osteochondrosis dissecans (3,19%) and three of osteonecrosis (0,27%) were seen in the same period. 60 synovectomies with 33 resections of the radial head were operated because of rheumatoid arthritis with massive destruction of the humeroradial joint.(ABSTRACT TRUNCATED AT 250 WORDS)