Diagnostic value of ultrasonography for clinical medial epicondylitis.
OBJECTIVE
To assess the ultrasonographic findings and to evaluate the value of ultrasonography as a diagnostic method for detecting clinical medial epicondylitis.


METHODS
A prospective, single-blind study.


METHODS
An outpatient rehabilitation clinic in a tertiary university hospital.


METHODS
Twenty-one elbows from 18 patients with clinical medial epicondylitis and 25 elbows without medial epicondylitis were evaluated.


METHODS
Not applicable.


METHODS
The clinical diagnosis of medial epicondylitis was based on the patient's symptoms and clinical signs in a physical examination performed by a physiatrist. An experienced radiologist made the real-time ultrasonographic diagnosis based on the detection of at least one of the following abnormal findings: a focal hypoechoic or anechoic area, tendon nonvisualization, intratendinous calcifications, and cortical irregularity.


RESULTS
Ultrasonography revealed positive findings in 20 of 21 elbows with medial epicondylitis and was negative in 23 of 25 without medial epicondylitis. Ultrasonography showed sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for clinical medial epicondylitis of 95.2%, 92%, 93.5%, 90.9%, and 95.8%, respectively. Tendinosis was observed in 15 elbows, and a partial-thickness tear, including 1 intrasubstance tear, was detected in 5 elbows. The most common ultrasonographic abnormality was a focal echogenic abnormality (15 hypoechoic, 5 anechoic) of the tendons.


CONCLUSIONS
Our results indicate that ultrasonography is informative and accurate for the detection of clinical medial epicondylitis. Therefore, ultrasonography should be considered as an initial imaging method for evaluating medial epicondylitis.
Park
Gi-Young
GY
Department of Rehabilitation Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea. parkgy@hotmail.com
Lee
Sung-Moon
SM
Lee
Michael Y
MY
D004551:Elbow Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016037:Single-Blind Method; D013710:Tendons / Q000000981:diagnostic imaging / Q000503:physiopathology; D013716:Tennis Elbow / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000534:rehabilitation; D018608:Ultrasonography, Doppler / Q000379:methods*