Ultrasound Used to Diagnose Medial Elbow Tendonitis

Studies show that ultrasound can be used to diagnose lateral epicondylitis (tennis elbow). But what about medial epicondylitis (golfer's elbow)? Can ultrasound be used as easily with as good of results?

The results of this study say, Yes. Ultrasound is informative and accurate in identifying signs of tendon degeneration along the inside of the elbow. In fact, ultrasound was a sensitive, specific, and accurate test for this condition.

Two groups of adults between the ages of 44 and 63 were tested with ultrasound. The first group had medial epicondylitis. All were diagnosed by a physician based on symptoms and physical exam. Tenderness around the elbow, range of motion, and strength were evaluated. Sensory function of the nerve was assessed based on examination of light touch and pinprick.

The second (control) group of adults did not have any elbow pain. There was no history of any elbow problems. X-rays were taken of everyone's elbows before the ultrasound exam. The ultrasound exam showed areas of tendon thickening, calcification within the tendons, and areas of increased circulation.

The ultrasound results made it possible to diagnose the problem as a tendinosis (tendon degeneration). Irregular surfaces and poorly defined tendon margins were signs other signs of tendinosis. Partial or full-thickness tears of tendon fibers were also visible.

Direction and speed of blood flow to the area could be seen using a special Doppler technique. The Doppler is a device used to measure the frequency and velocity of a moving substance such as blood.

The authors recommend using real-time (not static) ultrasound to diagnose medial epicondylitis. Ultrasound is very suitable for examining tendons. Information on the severity and stage of tendon degeneration can be determined. This information is useful when planning treatment.

References: Gi-Young Park, MD, PhD, et al. Diagnostic Value of Ultrasonography for Clinical Medial Epicondylitis. In Archives of Physical Medicine and Rehabilitation. April 2004. Vol. 89. No. 4. Pp. 738-742.