BACKGROUND: Lateral epicondylopathy (LE) is a common overuse injury affecting elbow, wrist, and hand function. It is characterized by weakness and pain in the muscles and tendons of the forearm responsible for the extension of your wrist and fingers. Trigger point dry needling is a technique reported to be beneficial in managing pain and dysfunction after LE diagnosis. LE is also commonly treated with conservative treatment, such as joint and soft tissue mobilization, self-care home programs, and anti-inflammatory use. We explored a different dry needling approach consisting of in situ dry needling with electric stimulation combined with targeted therapeutic exercise to treat LE in 3 cases.
METHODS: Three patients were referred for dry needling once a week for 6 weeks and home-based exercise therapy for LE. They were clinically evaluated using grip strength, a visual analog scale to assess pain, and Patient-Rated Tennis Elbow Evaluation Test scores. These were measured at 4 time points (weeks 0, 2, 4, and 6).
METHODS: The dry needling intervention incorporated 8 locations in the upper-extremity with 2 electric stimulation channels. The patients had reduced pain as measured by a visual analog scale, increased function as measured by the Patient-Rated Tennis Elbow Evaluation Test, and increased grip strength over 6 weeks.
CONCLUSIONS: This case series illustrates the use of dry needling and a home exercise program to provide a favorable outcome in a patient with LE. Patients had an 80% to 100% reduction in pain and similar improvements in function that were significantly beyond the minimum clinically important difference. This dry needling approach is a safe and effective treatment of LE in the short term.

UNASSIGNED: Tennis elbow (lateral epicondylitis elbow) is a self-limiting disease of indeterminate pathogenesis. Conservative therapy is the treatment of choice. In chronic tennis elbow with failure of conservative therapy; surgical treatment is a method of choice. Percutaneous tenotomy of extensor origin for patients with chronic tennis elbow is a minimally invasive technique with better long-term outcomes.
UNASSIGNED: Ten patients (six males, four females) presented with chronic tennis elbow, who did not respond to conservative treatment/non-surgical intervention for more than 6 months underwent percutaneous tenotomy in an outpatient setting. Two patients were lost to follow-up at 2 months\' post-operative. The remaining eight patients were evaluated at a mean follow-up of 3 years and assessed using the numerical rating scale, disabilities of the arm, shoulder and hand questionnaire ,and Oxford elbow score. These scores had a statistically significant difference in baseline to 3-year follow-up values (P < 0.05). No adverse outcomes, recurrence of symptoms, and signs of lateral epicondylitis elbow were noted and none required open surgical release.
UNASSIGNED: Percutaneous tenotomy, a minimally invasive technique is an effective and well-tolerated treatment for chronic tennis elbow and gives good pain relief and functional recovery.

The condition known as tendonitis, tennis elbow, lateral epicondylalgia, or lateral epicondylitis affects the radiohumeral joint and causes persistent, severe discomfort in the elbow. It commonly affects those who work in professions that need repetitive forearm motions, like athletes who play on courts, computer operators, and woodworkers. It tends to originate from additional rapid, tiresome, recurring eccentric contractions and activities that grab gliding joints. It commonly affects the dominant hand. This case report describes the author\'s seven years of experience living with lateral epicondylitis, including functional disability in day-to-day life, and then physiotherapy management was started. Mill\'s and Cozen\'s tests were performed, and lateral epicondylitis was confirmed. From 2023, the physiotherapy session, including active release technique and conventional therapy, was taken regularly for four weeks. The outcome measure score of the Visual Analog Scale (VAS) was 7/10 pre-treatment and 2/10 post-treatment, and for the Patient-Rated Tennis Elbow Evaluation (PRTEE) scale, it was 50/100 pre-treatment and 25/100 post-treatment. The results that are reported from this particular case study suggest that physiotherapy has a significant effect in improving muscle strength, increasing range of motion, improving activities of daily living, and enhancing the overall quality of life. The study concludes a physiotherapist is crucial in treating these overuse injuries and returning the patient to their daily activities.

UNASSIGNED: Common extensor tendinopathy is a common cause of lateral elbow pain. Ultrasound-guided minimally invasive tenotomy (MIT) has been utilized successfully as a treatment for several years, but the use of TenJet device has not been well described.
UNASSIGNED: To evaluate the effectiveness and safety of MIT with TenJet who failed nonsurgical management of common extensor tendinopathy in an outpatient setting.
UNASSIGNED: A total of 100 patients with common extensor tendinopathy who failed conservative treatment underwent ultrasound-guided MIT with TenJet device in the outpatient setting at a single institution. All 100 patients prior to MIT underwent diagnostic musculoskeletal ultrasound showing common extensor tendinosis. The findings were interpreted by a fellowship-trained and board-certified musculoskeletal radiologist. Patients were evaluated with the Oxford Elbow Score prior to the procedure and at 1-year follow-up. Exclusion criteria included prior corticosteroid injection within the past 6 weeks of the MIT intervention, active local or systemic infection, complete full thickness tear of the common extensor tendon, and pregnancy.
UNASSIGNED: Oxford Elbow Score had a statistically significant difference in baseline to 1 year (P < .001). No complications were reported and zero patients went on to require open surgical intervention.
UNASSIGNED: MIT with TenJet is a safe, effective, and well-tolerated treatment for common extensor tendinopathy.

UNASSIGNED: Complete avulsion of the common extensor origin of the elbow is a very rare injury which significantly weakens upper limb function. The restoration of the extensor origin is indispensable to the function of the elbow. There are very few reports of such injuries and their reconstruction.
UNASSIGNED: We present a case report of a 57-year-old male who presented with pain and swelling of elbow with inability to lift objects for 3 weeks. We diagnosed a complete common extensor origin rupture due to prior degeneration after corticosteroid injection for tennis elbow. The patient underwent reconstruction of the extensor origin with suture anchor. His wound healed well and he was mobilized from 2 weeks onward. At 3 months, he had full recovery of range of movement.
UNASSIGNED: It is crucial to diagnose these injuries, reconstruct them anatomically, and ensure good rehabilitation for optimum results.

Lateral elbow tendinopathy (LET) is a common overuse injury with complex underlying pathophysiological mechanisms. Although several modes of exercise with or without passive interventions have been recommended as the first-line treatment option of the condition, their effectiveness remains inconclusive. The aim of this case report is to evaluate the effect of wrist extensor exercises with blood flow restriction (BFR) as an add-on intervention to a multi-modal physiotherapy programme to improve outcomes in a patient with LET. A 51-year-old male patient presented with a history of right LET for six months. Interventions included wrist extension exercise with BFR, a two-stage progressive loading training programme of the upper limb, soft-tissue massage, education and a home exercise programme for six weeks (12 visits). A substantial improvement in pain intensity, pain-free grip strength, Patient Rated Tennis Elbow Evaluation score and self-perceived recovery was reported at three-, six-, and 12-week follow-up measurements. A 21% reduction in pressure pain thresholds at the lateral epicondyle was found immediately after wrist extensor exercise with BFR. Based on our findings, adding wrist extensor exercises with BFR to a multimodal physiotherapy programme seems a promising approach to improve the treatment outcome in LET. Nonetheless, further research is needed to confirm the present results.

UNASSIGNED: Posterior radiocapitellar synovial plica excision is sometimes performed for lateral epicondylitis after debridement of the extensor carpi radialis brevis (ECRB) tendon. We describe a rare intra-articular abnormality of the posterior radiocapitellar joint diagnosed on posterior arthroscopic observation.
UNASSIGNED: A 48-year-old man presented with posterolateral pain and discomfort in his left elbow. A diagnosis of lateral epicondylitis was made, and arthroscopic debridement of the ECRB tendon was performed. Posterior arthroscopic examination revealed a tendon-like abnormality running longitudinally along the articular surface of the capitulum of the humerus. The abnormality was resected using a shaver, and symptoms improved postoperatively.
UNASSIGNED: In patients with posterolateral pain and discomfort or catching of the elbow, posterior arthroscopic confirmation of the intra-articular structure is recommended after debridement of the ECRB tendon.

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BACKGROUND: International consensus is needed on case definitions of work-related musculoskeletal disorders and diseases (MSDs) for use in epidemiological research. We aim to: 1) study what information is needed for the case definition of work-related low back pain (LBP), lumbosacral radicular syndrome (LRS), subacromial pain syndrome (SAPS), carpal tunnel syndrome (CTS), lateral and medial elbow tendinopathy, and knee and hip osteoarthritis, and to 2) seek consensus among occupational health professionals/researchers regarding the case definitions of these work-related MSDs.
METHODS: A two-round Delphi study was conducted with occupational health professionals/researchers from 24 countries. Definition of work-related MSDs were composed of a case definition with work exposures. Round 1 included 32 case definitions and round 2, 60 case definitions. After two rounds, consensus required 75% of the panellists to rate a case definition including work exposures ≥7 points on a 9-point rating scale (completely disagree/completely agree).
RESULTS: Fifty-eight panellists completed both rounds (response rate 90%). Forty-five (70%) panellists thought that for LBP a case definition can be based on symptoms only. Consensus was only reached for work-related medial elbow tendinopathy, while the lowest agreement was found for knee osteoarthritis. Where consensus was not reached, this was - except for LBP - related to physical examination and imaging rather than disagreement on key symptoms.
CONCLUSIONS: Consensus on case definitions was reached only for work-related medial elbow tendinopathy. Epidemiological research would benefit from harmonized case definitions for all MSDs including imaging and physical examination for LRS, SAPS, CTS, lateral elbow tendinopathy and hip and knee osteoarthritis.

Radial tunnel syndrome (RTS) is an uncommon controversial entity thought to cause chronic lateral proximal forearm pain due to compression of the deep branch of the radial nerve, without paralysis or sensory changes. Diagnostic confusion for pain conditions in this region results from inconsistent definitions, terminology, tests, and descriptions in the literature of RTS and \"tennis elbow,\" or lateral epicondylitis. A case of bilateral RTS with signs discordant with traditionally used clinical diagnostic tests was successfully relieved with surgical decompression and led us to perform a comprehensive critical review of the condition. We delineate the controversy surrounding its diagnosis and aim to facilitate appropriate management and identify other areas for further study in this controversial condition. Clinical validity and evidence of anatomical rationale for the traditionally used Maudsley\'s provocative test is unclear in diagnosis of RTS or in chronic lateral elbow pain, if at all. Neither imaging nor electrophysiological studies contribute to a clinical diagnosis which is supported by short-term improvement after an injection with long-acting local anesthetic and corticosteroid. Accurate diagnosis and treatment of RTS can significantly improve quality of life, but validity and evidence for traditional clinical tests and definitions must be clarified.