513985178-tennis-and-golfer-elbow.pdf...

Tenis and golfer elbow simply detail of medial and lateral epicondylitis of bone .it is disorder of upper limb diagnosis by x ray ct mri ultrasound etc

1. TENNIS
ELBOW
ABHAY JAIN
126

2. INTRODUCTION
•Pain and tenderness at the lateral
epicondyle of the humerus due to non-
specific inflammation at the origin of
the extensor muscles of the forearm
•Tendinosis that affects the common
attachment of tendons of extensor
muscles of forearm(esp. ECRB)
•Also known as lateral epicondylitis (but
not an inflammatory condition)

3. ETIOLOGY
•Popularly associated while
playing tennis
•But more common in non tennis
players (95%)
• Any activity that involves
overuse of wrist extensors or
supinator muscles
•repeating the same motion over
and over again
•Carrying heavy loads

4. PATHOPHYSIOLOGY
•Stage 1 : acute inflammation but no angioblastic invasion (patient c/o
pain during activity)
•Stage 2 : c/c inflammation + some angioblastic invasion (pain both
during activity and rest)
•Stage 3 : c/c inflammation with extensive angioblastic invasion (rest
pain, night pains, pain during daily activities)

5. CLINICAL FEATURES
•Tenderness, precisely localised to the
lateral epicondyle of the humerus
•Pain is aggravated by putting the
extensor tendons to a stretch
•Painful and weak grip
•Cozen’s or thompson’s test - wrist
extension, radial deviation and full
pronation against resistance - pain at
anterolateral elbow

6. •Maudsley’s test - restricted
extension of middle finger
elicits pain at the lateral
epicondyle due to disease in
the extensor digitorum
communis
•Mill‘s test - wrist flexion +
forearm pronation + elbow
extension - pain
•Chair lift test - lift chair with
thumb, index & middle finger
+ elbow extension - pain

7. TREATMENT
•Rest your arm and avoid the activity that causes
your symptoms for at least 2 - 3 weeks
•Put ice on the outside of your elbow 2 - 3 times a
day
•The patient is initially treated with analgesics–anti
inflammatory drugs for a week or so
•If there is no response, a local injection of
hydrocortisone at the point of maximum tenderness
generally brings relief
•Compression strap applied distal to bulk of extensor
mass(to reduce maximum contraction). It is used
only during aggravating activity.

8. GOLFER’S
ELBOW

9. INTRODUCTION
•Inflammation is at the origin of the
flexor tendons at the medial
epicondyle of the humerus
•Also known as medial epicondylitis
•Pain on inside of the elbow

10. CAUSES
•overusing the muscles in the forearm
that allow you to grip, rotate your arm
and flex your wrist
•Repetitive flexing , gripping or swinging
can cause pulls or tiny tears in the
tendons
•Racket sports (small, heavy or tight)
and throwing sports (improper pitching
techniques)
•Occupations requiring strong hand grip
and adduction of elbow

11. CLINICAL FEATURES
•Tenderness under medial epicondyle
•Pain when shaking hands
•Weak grasping
•Numbness and tingling from your
elbow up and into your pinky and
ring fingers
•Pain when flexing your wrist

12. TREATMENT
•Restrict activities and movement of the elbow and
take adequate rest to gradually diminish the pain.
•Ice Pack: Application of ice wraps for 15 to 20 minutes
at a time, three to four times a day for several days.
•The patient is initially treated with analgesics–anti
inflammatory drugs for a week or so
•If there is no response, a local injection of
hydrocortisone at the point of maximum tenderness
generally brings relief
•Brace (compression strap): Putting a brace on the
elbows hinders free movement and reduces tendon
and muscle strain.

13. THANK
YOU