Reece Christopher L., Li Daniel, SUSMARSKI ADAM J.
Walter Reed National Military Medical Center
Cleveland Clinic, Northwestern University, The Ohio State University
Epicondylitis, a common cause of elbow pain in athletes and the general population, affects the medial and lateral epicondyles of the elbow, with lateral epicondylitis being significantly more prevalent. Medial epicondylitis, also known as golfer's or thrower's elbow, involves the chronic tendinosis of flexor-pronator muscles attaching to the medial epicondyle of the humerus, typically due to overuse or repetitive stress. This muscle group includes the pronator teres and the common flexor tendon, which encompasses the tendons of the flexor digitorum superficialis, flexor carpi ulnaris, flexor carpi radialis, and palmaris longus, with the flexor carpi radialis and pronator teres being most commonly affected. The medial epicondyle also acts as the origin for the ulnar (medial) collateral ligament, with the common flexor tendon and ulnar collateral ligament contributing to the elbow's stability against flexion and valgus forces. The ulnar nerve runs behind the medial epicondyle within the cubital tunnel. Although the term epicondylitis implies inflammation, a more accurate description for chronic cases could be epicondylosis or epicondylalgia, reflecting the condition's underlying degenerative nature and the formation of granulation tissue, known as angiofibroblastic hyperplasia or tendinosis. This terminology highlights the absence of a clear inflammatory process, although the early stages of the condition might still involve inflammation.
肱骨髁炎是运动员和普通人群肘部疼痛的常见原因，影响肘部的内上髁和外上髁，其中外侧肱骨髁炎更为普遍。内侧肱骨髁炎，也称为高尔夫球肘或投手肘，涉及附着于肱骨内上髁的屈肌-旋前肌的慢性肌腱病，通常是由于过度使用或反复受力所致。该肌肉群包括旋前圆肌和共同屈肌腱，共同屈肌腱包含指浅屈肌、尺侧腕屈肌、桡侧腕屈肌和掌长肌的肌腱，其中桡侧腕屈肌和旋前圆肌最常受累。内上髁也是尺侧（内侧）副韧带的起点，共同屈肌腱和尺侧副韧带有助于肘部抵抗屈曲和外翻力的稳定性。尺神经在肘管内沿内上髁后方走行。虽然术语“髁炎”意味着炎症，但对于慢性病例，更准确的描述可能是髁病或髁痛，这反映了该病症潜在的退行性本质以及肉芽组织的形成，即血管纤维母细胞增生或肌腱病。这个术语突出了不存在明确的炎症过程，尽管该病症的早期阶段可能仍涉及炎症。
