Case Of the Week (COW) 08 Sep 2013
Answer:
Medial Epicondylitis and Ulnar Neuritis(Golfer`s elbow)
Findings:
STIR hyperintensities reflecting Edema noted at insertion of common flexor tendons at medial epicondyle. STIR hyperintensities are also noted in Ulnar nerve.
Discussion:
Golfer`s Elbow is medial tendinosis of the wrist –flexor Pronator group and is less common than lateral epicondylitis . The common flexor tendon originates at the medial epicondyle, providing attachment for three flexors of the wrist , which are from anterior to posterior, the flexor carpi radialis, the palmaris longus,and the flexor carpi ulnaris It is associated with sports like squash, golf , bowling and tennis. Symptoms are due to local inflammation causing compression neuropathy of ulnar nerve. It is important to differentiate Medial Epicondylitis from Ulnar collateral ligament complex insufficiency , which has a relatively acute onset in contrast to the insidious onset of the former.
Ref: MRI of the Upper Extremity: Shoulder, Elbow, Wrist and Hand-- Christine B. Chung, Lynne S. Steinbach
Dr. Babu Peter MD, DNB
Associate Professor, Barnard Institute of Radiology
Senior Consultant Radiologist, Aarthi Scans, Chennai
Answer:
Medial Epicondylitis and Ulnar Neuritis(Golfer`s elbow)
Findings:
STIR hyperintensities reflecting Edema noted at insertion of common flexor tendons at medial epicondyle. STIR hyperintensities are also noted in Ulnar nerve.
Discussion:
Golfer`s Elbow is medial tendinosis of the wrist –flexor Pronator group and is less common than lateral epicondylitis . The common flexor tendon originates at the medial epicondyle, providing attachment for three flexors of the wrist , which are from anterior to posterior, the flexor carpi radialis, the palmaris longus,and the flexor carpi ulnaris It is associated with sports like squash, golf , bowling and tennis. Symptoms are due to local inflammation causing compression neuropathy of ulnar nerve. It is important to differentiate Medial Epicondylitis from Ulnar collateral ligament complex insufficiency , which has a relatively acute onset in contrast to the insidious onset of the former.
Ref: MRI of the Upper Extremity: Shoulder, Elbow, Wrist and Hand-- Christine B. Chung, Lynne S. Steinbach
Dr. Babu Peter MD, DNB
Associate Professor, Barnard Institute of Radiology
Senior Consultant Radiologist, Aarthi Scans, Chennai