An overview of ultrasonography in lateral epicondylitis: Correlation with disease duration and severity

Abstract

The purpose of this study is to make an overview for ultrasonographic features of lateral epicondylitis and to investigate the correlation of these features with clinical findings including disease duration and severity. This prospective study included 42 consecutive patients diagnosed with lateral epicondylitis on clinical examination. Three patients had bilateral involvement, therefore 45 elbows were examined with ultrasonography. In addition the asymptomatic contralateral 39 elbows of 39 patients and as a control group, 16 elbows of 16 healthy asymptomatic volunteers were examined. The ultrasonographic features of lateral epicondylitis in common extensor tendon including focal hypoechoic area, heterogenicity, focal areas of calcification, increase or decrease in thickness, partial or complete tear, peritendinous fluid collection and entesophyte were investigated. These findings were compared with the clinical findings including the duration and severity of complaint. Visual analog scale (VAS) was used to evaluate the severity of pain. Fisher exact test and Mann-Whitney U test were used in statistical analysis, and all tests were considered significant at p < .05 in 95% CIs. In the diseased elbows, the most common finding of the lateral epicondylitis was heterogenicity, focal hypoechoic area and entesophyte, respectively. Statistical examination revealed no significant correlation between ultrasonographic findings and duration of the symtoms. There was also no significant correlation between ultrasonographic findings and severity of pain. Ultrasonography can demonstrate well the features of lateral epicondylitis. It could also be helpful to show the extent of the disease. However, ultrasonographic findings do not significantly correlate with duration and severity of the disease clinically.