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MR imaging of epicondylitis
1Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
Skeletal Radiology
|April 29, 1998
Summary
Magnetic resonance imaging (MRI) of epicondylitis shows tendon thickening and increased T1 and T2 signals. However, these findings can appear in asymptomatic individuals, with anconeus edema rarely observed.
Area of Science:
- Orthopedics
- Radiology
- Sports Medicine
Background:
- Epicondylitis, commonly known as tennis elbow or golfer's elbow, is a condition characterized by pain and inflammation of the tendons attaching to the epicondyle of the humerus.
- Accurate diagnosis is crucial for effective treatment and management.
- Magnetic resonance imaging (MRI) offers detailed visualization of soft tissues, making it a valuable tool for evaluating musculoskeletal conditions.
Purpose of the Study:
- To systematically evaluate the magnetic resonance imaging (MRI) findings in patients diagnosed with epicondylitis.
- To compare these findings with those observed in asymptomatic volunteers.
- To identify characteristic MRI features of epicondylitis and assess their prevalence in healthy individuals.
Main Methods:
- A case-control study was conducted involving 43 participants: 24 with clinically diagnosed epicondylitis and 19 asymptomatic volunteers.
- MRI examinations were performed using a 1.5 T scanner with specific sequences: axial T1-weighted, axial fat-saturated fast spin-echo (FSE), and coronal or sagittal Fast Short Tau Inversion Recovery (STIR).
- Two independent radiologists assessed the images for intratendinous signal intensity, tendon thickening, periosteal reaction, fluid in the radial head bursa, and anconeus edema.
Main Results:
- All patients with epicondylitis exhibited increased signal intensity on fat-saturated FSE and Fast STIR sequences.
- Tendon thickening was observed in 19 patients, and increased intratendinous T1 signal in 22 patients.
- Fluid in the radial head bursa and periosteal reaction were not detected in any patient. Anconeus edema was rare, seen in only two patients. Three patients unexpectedly showed increased T2 signal within the epicondyle.
Conclusions:
- MRI findings for epicondylitis typically include tendon thickening with increased T1 and T2 signal intensity.
- These imaging features, however, can be present in a small percentage of asymptomatic individuals, particularly athletes.
- Anconeus edema and radial head bursa distension, previously reported, were infrequently observed in this study, suggesting limited diagnostic utility for these specific findings in epicondylitis evaluation.