Case Of the Week (COW) 10 January 2016
Lateral epicondylitis
Findings
Undersurface partial tear of the common extensor tendon origin. The radial collateral ligament is mildly thickened but intact.
Discussion
Discussion Best diagnostic clue for diagnosis of lateral epicondylitis is abnormal thickening and increased signal intensity within the common extensor origin from the lateral epicondyle Abnormal thickening & abnormal separation of the radial collateral ligaments and the extensor carpi radials brevis (ECRB) with granulation tissue Partial or even full thickness tear of the ECRB complicating tendinosis may be encountered in patient with lateral epicondylitis. It is manifested as fluid filled gap with or without loss of fiber continuity. Peritendon edema and associated focal bone marrow edema at the site of tendon attachment to the humerus may simulate avulsion injury Partial thickness tears almost always occur as an undersurface partial avulsion of the common extensor origin from the lateral epicondyle. Both complete and partial tears typically demonstrate T2 hyperintensity, resulting from fluid filling the tendon defect. Coronal T2-weighted fat-suppressed images are best for making this diagnosis. In chronic cases increased signal intensity of the nearby anconeus muscle may be seen associated radial nerve entrapment may occur in 5% of cases radial collateral ligament may also be disrupted.
Reference: Radiopedia
Contributed By:
Dr Balaji Ayyamperumal
Tanjavur Medical College
Lateral epicondylitis
Findings
Undersurface partial tear of the common extensor tendon origin. The radial collateral ligament is mildly thickened but intact.
Discussion
Discussion Best diagnostic clue for diagnosis of lateral epicondylitis is abnormal thickening and increased signal intensity within the common extensor origin from the lateral epicondyle Abnormal thickening & abnormal separation of the radial collateral ligaments and the extensor carpi radials brevis (ECRB) with granulation tissue Partial or even full thickness tear of the ECRB complicating tendinosis may be encountered in patient with lateral epicondylitis. It is manifested as fluid filled gap with or without loss of fiber continuity. Peritendon edema and associated focal bone marrow edema at the site of tendon attachment to the humerus may simulate avulsion injury Partial thickness tears almost always occur as an undersurface partial avulsion of the common extensor origin from the lateral epicondyle. Both complete and partial tears typically demonstrate T2 hyperintensity, resulting from fluid filling the tendon defect. Coronal T2-weighted fat-suppressed images are best for making this diagnosis. In chronic cases increased signal intensity of the nearby anconeus muscle may be seen associated radial nerve entrapment may occur in 5% of cases radial collateral ligament may also be disrupted.
Reference: Radiopedia
Contributed By:
Dr Balaji Ayyamperumal
Tanjavur Medical College