Lateral elbow tendinosis: a review of diagnosis and management in general practice

摘要

Lateral elbow tendinosis (LET), commonly known as tennis elbow, lateral epicondylitis, or lateral epicondylalgia, carries significant disease burden of 2.5 to 3.5 per 1000.1,2 Affecting the extensor tendons on the lateral aspect of the forearm, this condition is most commonly seen in middle-aged patients with a peak incidence between 40 and 50 years.3 There is a higher prevalence among those working in high-risk industries (involving loaded and repeated gripping and/or wrist extension activities)2,4 and players of racquet sports.3 The majority of cases are self-limiting, with up to 80% improving within 12 months,3,4 although LET can result in considerable individual morbidity, substantial healthcare resource utilisation, and lost time from work.1,5The most commonly implicated of the extensor tendons is the extensor carpi radialis brevis (ECRB), and, although traditionally thought of as an inflammatory process, more recent histological examination suggests LET is a tendinosis. The combination of excessive loading in the context of individual risk factors — age, occupation, hobbies, or previous injury — causes the transition from normal tendon through to degenerative tendinosis.3,5,6LET classically presents with insidious pain …