Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 138-738, Korea.
Department of Radiology, Gachon University, Gil Medical Center, Incheon, Korea.
Eur Radiol. 2018 Mar;28(3):972-981. doi: 10.1007/s00330-017-5084-5. Epub 2017 Oct 12.
We assessed the implications of MR imaging with clinical history in lateral epicondylitis management by evaluating imaging and clinical features in patients with lateral epicondylitis treated conservatively or operatively.
Sixty patients with lateral epicondylitis treated conservatively (n = 38) or operatively (n = 22) from 2011-2015 were included. MR imaging findings of common extensor tendon (CET), lateral collateral ligament (LCL) complex, muscle oedema, ulnar nerve and elbow joint were reviewed. Clinical data recorded were frequency, duration and intensity of pain, history of trauma and injection therapy, range of motion.
MRI-assessed CET and LCL complex abnormalities, muscle oedema, radiocapitellar joint widening, joint effusion/synovitis, pain frequency and intensity differed significantly between the two groups (p < .05) with increased severity in operative group. Persistent pain (OR 12.2, p < .01), CET abnormality on longitudinal plane (OR 7.5, p = .03 for grade 2; OR 22.4, p < .01 for grade 3) and muscle oedema (OR 6.7, p = .03) were major factors associated with operative treatment. Area under the ROC curve of predicted probabilities for combination of these factors was 0.83.
MR imaging, combined with clinical assessment, could facilitate appropriate management planning for patients with lateral epicondylitis.
• MRI can reflect different disease severity between patients treated conservatively/operatively. • CET abnormality, muscle oedema were major MRI findings with operative treatment. • Patients in operative group were more likely to experience persistent pain. • MRI plus clinical symptoms could facilitate appropriate management for lateral epicondylitis.
通过评估患有保守或手术治疗外侧髁炎患者的影像学和临床特征，评估磁共振成像（MRI）与临床病史在外侧髁炎管理中的意义。
纳入了 2011 年至 2015 年间接受保守治疗（n = 38）或手术治疗（n = 22）的 60 例外侧髁炎患者。回顾了常见伸肌腱（CET）、外侧副韧带（LCL）复合体、肌肉水肿、尺神经和肘关节的 MRI 表现。记录的临床数据包括疼痛的频率、持续时间和强度、外伤和注射治疗史、关节活动度。
MRI 评估的 CET 和 LCL 复合体异常、肌肉水肿、桡尺骨关节增宽、关节积液/滑膜炎、疼痛频率和强度在两组之间差异有统计学意义（p <.05），手术组的严重程度更高。持续性疼痛（OR 12.2，p <.01）、CET 在矢状面异常（OR 7.5，p =.03，等级 2；OR 22.4，p <.01，等级 3）和肌肉水肿（OR 6.7，p =.03）是与手术治疗相关的主要因素。这些因素组合的预测概率的 ROC 曲线下面积为 0.83。
MRI 结合临床评估，可以为外侧髁炎患者提供适当的管理计划。
• MRI 可以反映接受保守/手术治疗患者的不同疾病严重程度。• CET 异常、肌肉水肿是手术治疗的主要 MRI 发现。• 手术组患者更有可能经历持续性疼痛。• MRI 结合临床症状有助于外侧髁炎的适当治疗。
