Lateral and Medial Epicondylitis

Epicondylitis of the elbow is a commonly encountered condition in people with elbow pain, with lateral epicondylitis involved more often than medial epicondylitis. Clinically, patients present with an insidious onset of pain about either the lateral or medial epicondyle, worsened with resisted wrist extension in the former and resisted wrist flexion in the latter. Concurrent conditions, however, may be present and must be evaluated for, especially when investigating medial elbow pain. While both conditions remain clinical diagnoses, MRI can provide valuable information, particularly in assessing the adjacent tissue for any concomitant pathology. Numerous conservative treatment options have been described and are usually effective. These include periods of rest, physical therapy, anti-inflammatory medication, injections (including corticosteroid and platelet-rich plasma), and trials of bracing. However, in recalcitrant cases, surgical intervention may be required. While traditionally performed with an open surgical debridement of the diseased tissue, arthroscopic treatment of epicondylitis has become more common. Additionally, arthroscopic treatment has been shown to provide equivalent, if not superior, clinical improvement with the potential for a quicker return to work and sporting activities.