Hung Chih-Chien, Chen Hsin-Shui, Chang Chih-Hao, Wang Ming-Wei, Hung Kun-Lin, Wang Hsing-Kuo
Department of Orthopedics, National Taiwan University Hospital Yunlin Branch, Douliu, Taiwan.
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Yunlin Branch, Douliu, Taiwan.
J Med Ultrasound. 2024 Sep 25;33(1):47-53. doi: 10.4103/jmu.jmu_22_24. eCollection 2025 Jan-Mar.
Manual workers are at risk of developing lateral elbow tendinopathy (LET). We aimed to validate the hypothesis that asymptomatic elbows of manual workers with LET are more likely to have positive physical examination results and morpho-mechanical changes on elbow ultrasonography compared to healthy individuals.
This cross-sectional case-control study included 30 manual workers with unilateral LET (LET group) and 30 age- and sex-matched healthy volunteers (control group). Demographic data collection and functional evaluation were performed using the Disabilities of the Arm, Shoulder, and Hand; Patient-Rated Tennis Elbow Evaluation; and European Quality of Life Five-Dimensions questionnaires. Physical examination of the elbows and evaluation of the common extensor tendon (CET) with B-mode morphology ultrasonography and Young's modulus elastography were performed. The LET-unaffected and LET-affected elbows in the LET group were compared with the elbows in the control group.
The LET-unaffected elbows in the LET group had a higher prevalence of positive chair test results and focal hypoechoic change and microcalcification on ultrasonography than those in the control group ( < 0.05, 0.005, and 0.05, respectively). In addition, LET-affected elbows showed higher focal hypoechoic change, microcalcification, erosive cortex, and neovascularity than elbows in the control group ( < 0.001, 0.001, 0.005, and 0.001, respectively). The unaffected and affected elbows showed greater CET thickness than those in the control group ( < 0.05 and 0.005).
The unaffected elbows of manual workers with unilateral LET should be considered at risk of LET. We proposed a risk assessment and surveillance protocol based on chair test results and abnormal ultrasonographic findings.
体力劳动者有患外侧肘肌腱病（LET）的风险。我们旨在验证以下假设：与健康个体相比，患有LET的体力劳动者无症状的肘部在体格检查中更有可能出现阳性结果，并且在肘部超声检查中更有可能出现形态学和力学变化。
这项横断面病例对照研究纳入了30名单侧LET的体力劳动者（LET组）和30名年龄及性别匹配的健康志愿者（对照组）。使用手臂、肩部和手部功能障碍量表、患者自评网球肘评估量表以及欧洲五维生活质量问卷进行人口统计学数据收集和功能评估。对肘部进行体格检查，并使用B型形态超声和杨氏模量弹性成像对伸肌总腱（CET）进行评估。将LET组中未受LET影响的肘部和受LET影响 的肘部与对照组的肘部进行比较。
LET组中未受LET影响的肘部在椅子试验中的阳性结果患病率更高，并且在超声检查中出现局灶性低回声改变和微钙化的情况比对照组更多（分别为P<0.05、P < 0.005和P < 0.05）。此外，受LET影响的肘部与对照组的肘部相比，出现局灶性低回声改变、微钙化、皮质侵蚀和新生血管的情况更多（分别为P < 0.001、P < 0.001、P < 0.005和P < 0.001）。未受影响和受影响的肘部的CET厚度均大于对照组（分别为P < 0.05和P < 0.005）。
单侧LET的体力劳动者未受影响的肘部应被视为有患LET的风险。我们基于椅子试验结果和异常超声检查结果提出了一项风险评估和监测方案。
