title: Epicondylitis: pathogenesis, imaging, and treatment.
abstract: Epicondylitis commonly affects the elbow medially or laterally, typically in the 4th or 5th decade of life and without predilection with regard to sex. Epicondylitis is an inflammatory process that may be more accurately described as tendinosis. In the lateral epicondylar region, this process affects the common extensor tendon; in the medial epicondylar region, the common flexor tendon is affected. The condition is widely believed to originate from repetitive overuse with resultant microtearing and progressive degeneration due to an immature reparative response. Advances in understanding of the anatomy and pathophysiology of epicondylitis have shaped current treatment practices. Conservative measures are undertaken initially, because symptoms in most patients improve with time and rest. Those who fail to respond to conservative therapy are considered for surgical treatment. When surgery is contemplated, magnetic resonance imaging or ultrasonography is useful for evaluating the extent of disease, detecting associated pathologic processes, excluding other primary sources of elbow pain, and planning the surgical approach. Familiarity with the normal anatomy, the pathophysiology of epicondylitis and its mimics, and diagnostic imaging techniques and findings allows more accurate diagnosis and helps establish an appropriate treatment plan.
authors.affiliation: Departments of Radiology and Orthopedic Surgery, New England Baptist Hospital, Boston, MA, USA. danwalz@hotmail.com
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Walz
authors.forename: Joel S
authors.initials: JS
authors.lastname: Newman
authors.forename: Gabrielle P
authors.initials: GP
authors.lastname: Konin
authors.forename: Glen
authors.initials: G
authors.lastname: Ross
mesh_terms: D000328:Adult; D000368:Aged; D003240:Connective Tissue Diseases / Q000175:diagnosis* / Q000628:therapy*; D003952:Diagnostic Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013710:Tendons / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D013716:Tennis Elbow / Q000175:diagnosis* / Q000601:surgery; D014463:Ultrasonography