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"The elbow" Demo Occup Med (Lond). 2003 Aug;53(5):309-12.

The objective diagnosis of early tennis elbow by magnetic resonance imaging.
Mackay D, Rangan A, Hide G, Hughes T, Latimer J.

Middlesbrough General Hospital, Ayresome Green Lane, Middlesbrough TS5 5AZ, UK.

OBJECTIVE: To identify the salient magnetic resonance imaging (MRI) features of tennis elbow. An objective diagnosis is important when managing work-related incapacity due to ill-defined lateral arm pain. METHOD: Twenty-three symptomatic and 17 asymptomatic elbows in 20 patients with tennis elbow, no evidence of other pathology and no previous treatment were imaged using established MRI sequences. RESULTS: In the symptomatic elbows, the common extensor origin (CEO) showed signs of oedema in 23, thickening in 19, peri-tendon oedema in 3 and tears in 13 cases. More extensive abnormalities were demonstrated in only two elbows. Six out of 17 asymptomatic elbows also showed oedema in the CEO. CONCLUSIONS: The CEO is confirmed as the primary site of MRI changes in tennis elbow. Oedema was commonly found in asymptomatic elbows, necessitating the presence of thickening or tears in the CEO tendon to objectively diagnose tennis elbow on MRI.

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