Lateral Epicondyle Enthesopathy: Symptoms Of Tennis Elbow

Lateral epicondyle enthesopathy, or tennis elbow, is a condition characterized by joint pain caused by repeated repetitive movements of the wrist.

Lateral epicondyle enthesopathy , commonly known as the tennis elbow, is an inflammation of the epicondyle tendons. These are ligaments that connect the muscles of the forearm and hand to the lateral epicondyle of the humerus, located on the outside of the elbow. Inflammation is caused by microtraumas resulting from overloading the muscles.

Read on to learn more about Tennis Elbow Symptoms and Diagnosis.

This disease is quite common among people who play sports, which is where its name comes from, but also in office workers. There are professions that are more likely to develop it due to the repetition of certain gestures.

This happens when working in factories, working at a computer, painting or other activities that require excessive effort of the muscles responsible for hand movements.

Tennis elbow symptoms

Symptoms of lateral epicondyle enthesopathy appear gradually. In most cases, patients usually notice pain on the outside of the elbow which may radiate to the forearm.

You may experience discomfort when grasping objects, moving your fingers, turning your wrist, and applying pressure to the affected area where the muscles connect to the ligaments. In addition, there may be a lack of strength in the forearm.

Lateral epicondyle enthesopathy: diagnosis

In the case of elbow pain, correct diagnosis plays an extremely important role in choosing the right treatment method. There are various medical conditions that all have similar symptoms, which can lead to making a mistake.

Epicondylitis, resistant to treatment due to a diagnostic error, usually occurs due to entrapment of the posterior interosseous nerve in the lateral regions of the elbow. Here are some medical conditions that can lead to a tennis elbow-like pain:

• Neuropathy due to entrapment of the radial nerve.
• Osteoarthritis and cartilage of the radius-radial joint.
• Pain in the surrounding muscles that, although not directly related to the area where you are feeling pain, can cause discomfort.

• Changes in the head of the radial bone, located on the outer part of the elbow.

To make a correct diagnosis of lateral epicondylitis enthesopathy, your doctor must follow these steps:

1. Medical history of the patient

• Visual examination: Your doctor will perform a careful examination of the physical appearance of the pain-affected area. He will look for signs of inflammation, skin changes, abnormalities in the position of the joint, etc.
• He will find the epicondyle and squeeze it to see if the patient is experiencing pain in that area.
• Elbow Varus Compression Test: Compression on the elbow that causes the circumferential part of the elbow to move towards the center axis of the body. The test will be positive if the patient feels uncomfortable.

• Pain that occurs when you straighten your fingers with resistance.
• Examination of the mobility of the elbow and the radial head, the cervical spine and the entire articular system of the arm.
• Gathering information about your child’s daily activities that may have an impact on the condition. All recent medications should be taken into account.

Pronation and supination

To understand the following studies, you need to understand the concepts of pronation and supination.

Supination is side rotation of the forearm and hand. The palm is pointing upwards and the thumb is pointing outwards. Pronation is rotating the forearm and hand towards the center of the body. In this case, the palm of the hand points towards the ground and the thumb towards the center of the body.

• Windmill maneuver. The patient remains in a sitting position, with slightly turned shoulders, with the palm of the back straightened and the arm bent at the elbow.
  • The physical therapist places one hand on the elbow and the other on the side of the forearm. He asks the patient to try to supine the forearm (turn the forearm outward and point the palm upwards) against the resistance exerted by the physiotherapist’s hand. If the patient feels pain during this movement, he or she probably develops lateral epicondyle enthesopathy.

• Chair test: The patient will be asked to raise the chair in two different ways. When he holds it with his hand pronated and his elbow stretched out, he will feel pain. However, there will be no discomfort when he grasps it with his hand in a supining position.

2. Other research

If, despite the above-mentioned tests, the doctor is not able to diagnose a tennis elbow, other follow-up tests should be performed:

• Analytical to exclude uric acid crystals in the joint caused by hyperuricemia.
• Electromyography to rule out nerve compression syndromes.
• Radiological and other complementary examinations.