Department of Anatomy, Jagiellonian University Medical College, Mikołaja Kopernika 12, 33-332, Kraków, Poland.
Youthoria, Youth Research Organization, Kraków, Poland.
Int Orthop. 2023 Jul;47(7):1787-1795. doi: 10.1007/s00264-023-05805-x. Epub 2023 Apr 18.
A great number of patients that suffer from lateral epicondylitis, commonly called tennis elbow (TE), are not successfully treated, meaning, not getting adequate therapeutic effects and the main origin of the pain not being handled appropriately. The hypothesis of the present study is that the inefficiency of the treatment of the chronic TE may often be due to underdiagnosis of posterior interosseous nerve (PIN) entrapment or and plica syndrome, as the authors believe that those pathologies can often occur simultaneously.
A prospective cross sectional study was conducted. A total of 31 patients met the required criteria.
Thirteen (40.7%) of the patients had more than one source of the lateral elbow pain. Five patients (15.6%) had all three examined pathologies. Six patients (18.8%) had TE and PIN syndrome. Two patients (6.3%) had TE and plica syndrome.
The present study demonstrated concomitant potential sources of lateral elbow pain in patients diagnosed with chronic TE. Our analysis shows how important it is to systematically diagnose patients that present with lateral elbow pain. The clinical characteristics of the three most common causes of chronic lateral elbow pain, meaning, TE, PIN compression, and plicae syndrome were also analyzed. Having adequate knowledge about the clinical aspects of these pathologies can help with a more effective differentiation of the etiology of chronic lateral elbow pain, and with that, a more efficient and cost-effective treatment plan.
许多患有外侧肱骨上髁炎(俗称网球肘)的患者治疗效果不佳,也就是说,没有获得足够的治疗效果,且主要疼痛源没有得到适当处理。本研究的假设是慢性 TE 的治疗无效通常可能是由于后骨间神经(PIN)嵌压或滑膜皱襞综合征的诊断不足,因为作者认为这些病理情况通常会同时发生。
进行了一项前瞻性的横断面研究。共有 31 名患者符合要求。
13 名(40.7%)患者的肘部外侧有不止一处疼痛源。5 名(15.6%)患者存在所有三种检查出的病变。6 名(18.8%)患者患有网球肘和 PIN 综合征。2 名(6.3%)患者患有网球肘和滑膜皱襞综合征。
本研究表明,患有慢性 TE 的患者可能存在同时存在多种潜在的肘部外侧疼痛源。我们的分析表明,对出现肘部外侧疼痛的患者进行系统诊断非常重要。还分析了慢性外侧肘部疼痛的三种最常见原因(即网球肘、PIN 压迫和滑膜皱襞综合征)的临床特征。充分了解这些病变的临床方面有助于更有效地鉴别慢性外侧肘部疼痛的病因,并制定更有效且更具成本效益的治疗计划。