Lateral epicondylitis

Today we will be looking at lateral epicondylitis.

It is one of the most important topics in Australian medical council and other international examinations.

Also it is one of the most commonly asked orthopaedic cases in the clinical exam.

So, What is lateral epicondylitis and let’s have a look at the case scenario.

The common case scenario is usually of a 30 to 40 years old young individual who is a mechanic or a carpenter and has come to you with pain on outside of the elbow. The usual history is of long standing nagging pain on the outside of the elbow which increases on work and is usually less at rest.

The usual task for this kind of scenario includes take a history and examination and then lead on to diagnosis and management.

History

The main thing to ask in history includes detail about pain and functional complaints. You need to ask a complete detail about pain.

Remember the MNEMONIC for pain

S o r t s a r a

So we need to ask the complete history about pain.we also need to ask how much is the functional limitation of the patient we need to ask him how much work can he do without major discomfort.

we also need to get a complete history of functional limitation in the recent times,so ask him has there been any major change recently in terms of what he can or cannot do.

Examination

Any orthopaedics examination consists of three things

Look look, feel, move.

LOOK

Inspection includes having a look at how the elbow looks like. You have to look for things like swelling redness and cuts or grazes and any signs of infection and similar things.

FEEL

Next is palpation. Palpation includes feeling for tenderness, swelling, bumps lumps etc.

MOVE

Last but not least is checking the movements at the elbow and checking how much pain is there on movements. This gives an indication of the severity of the problem and what needs to be done.

Diagnosis and treatment

diagnosis is primarily clinical on the history and examination. Treatment worlds removing the causative factor and giving pain relief.

Rest ice compression and elevation is the main form of treatment. This is usually followed by physiotherapy. armband support also helps in pain relief however the most important thing is to remove the cost of factor.

Next is local steroid injection which can usually give pain relief for up to 3 months. If things are not improving despite these treatments for a long period of time we need to think about surgical intervention.

Surgical interventions usually involve releasing the extensor origin from the lateral epicondyle and reinforcing with anchors.

Hope you liked this topic.

Please keep coming back for more.

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