title: MR findings in humeral epicondylitis. A systematic review.
abstract: OBJECTIVE
  To highlight the importance of meta-analysis in diagnostic imaging by presenting a systematic search of the literature on the accuracy of MR imaging in epicondylitis.
  
  
  METHODS
  The literature was comprehensively reviewed to identify studies on MR findings in epicondylitis. Reviewers blind to the clinical diagnoses screened the data according to predetermined inclusion criteria. Data were collected and validity and relevance were assessed on structured forms.
  
  
  RESULTS
  Seven studies including 148 patients with epicondylitis were accepted for the analysis. Eleven asymptomatic contralateral elbows and 29 elbows of healthy volunteers served as controls. The volunteers were distinctly younger than the patients. The MR technique was divergent, and the observed pathological changes also varied. The most frequent alteration was a change in the common extensor tendon signal (90%, 95% confidence interval 84-94%); 14% of the healthy volunteers and 50% of the contralateral elbows displayed the similar alteration.
  
  
  CONCLUSIONS
  Small sample size and methodological shortcomings in the original studies make the assessment of MR findings in epicondylitis questionable. There is a need for well-designed studies in which clinical features and occupational backgrounds as well as imaging parameters are carefully documented.
authors.affiliation: Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: I
authors.initials: I
authors.lastname: Pasternack
authors.forename: E M
authors.initials: EM
authors.lastname: Tuovinen
authors.forename: M
authors.initials: M
authors.lastname: Lohman
authors.forename: T
authors.initials: T
authors.lastname: Vehmas
authors.forename: A
authors.initials: A
authors.lastname: Malmivaara
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D013716:Tennis Elbow / Q000175:diagnosis*