SEARCH RESULTS FOR: medial-epicondylitis-golfers-elbow-pathogenesis-and-clinical-findings

medial-epicondylitis-golfers-elbow-pathogenesis-and-clinical-findings

Medial Epicondylitis (Golfer’s Elbow): Pathogenesis and clinical findings Intrinsic Factors: age, body weight, nutrition, gender, anatomical variations, joint laxity, systemic disease, muscle weakness / imbalance, vascular perfusion Micro-tears within flexor-pronator tendons initiating healing process: inflammation, proliferation, and remodeling (see acute wound healing slide) Continued repetitive strains with inadequate recovery time between activitiesàhealing unable to meet tissue damage Authors: Brett Lavender Reviewers: Alyssa Federico, Liam Thompson, Tara Shannon, *Gerhard Nikolaus Kiefer * MD at time of publication Extrinsic Factors: activities involving repeated forceful use of the flexor-pronator muscle groups (sports including golf and baseball, activities such as shoveling, gardening or hammering nails) Ineffective revascularization of damaged tissue MRI or Ultrasound Findings: Tendon thickening, partial tears, disrupted vascular distribution +/- edema of surrounding tissues Disorganized collagen formation and scarring à↑ type III collagen (most common collagen involved with wound healing) ↑ Tendon thickening Decreased tensile strength of tendon Weakness of the flexor-pronator muscle groups ↑ Nerve growth within damaged tissue (consequence of healing response) Local nerves are compressed by thickened tendonànociceptors within tendon are activated (Ulnar nerve passes through cubital tunnel adjacent to medial epicondyle) Ulnar paresthesias may result to structures innervated distal to the cubital tunnel Medial Epicondylitis Tendinosis at the common flexor-pronator origin at the medial epicondyle of the humerus Pain with passive wrist extension or resisted flexion Tenderness over the proximal wrist flexor-pronator muscles Pain localized to medial epicondyle Severity ranges from mild to severe based on the effect on patient activities Mild tendinopathy: patient continues most activities with minor pain Moderate tendinopathy: patient continues some activities with modifications Severe tendinopathy: patient’s daily activities are impacted by severe pain Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Published August 30, 2022 on www.thecalgaryguide.com