Diagnostic Value of Ultrasonography for Clinical Medial Epicondylitis
- Affiliated Author(s)
- 이성문; 박기영
- Alternative Author(s)
- Lee, Sung Mun; Park, Gi Young
- Journal Title
- Archives of Physical Medicine and Rehabilitation
- Issued Date
- Objectives: To assess the ultrasonographic findings and to
evaluate the value of ultrasonography as a diagnostic method
for detecting clinical medial epicondylitis.
Design: A prospective, single-blind study.
Setting: An outpatient rehabilitation clinic in a tertiary university
Participants: Twenty-one elbows from 18 patients with
clinical medial epicondylitis and 25 elbows without medial
epicondylitis were evaluated.
Interventions: Not applicable.
Main Outcome Measures: The clinical diagnosis of medial
epicondylitis was based on the patient’s symptoms and clinical
signs in a physical examination performed by a physiatrist. An
experienced radiologist made the real-time ultrasonographic
diagnosis based on the detection of at least one of the following
abnormal findings: a focal hypoechoic or anechoic area, tendon
nonvisualization, intratendinous calcifications, and cortical
Results: Ultrasonography revealed positive findings in 20 of
21 elbows with medial epicondylitis and was negative in 23 of
25 without medial epicondylitis. Ultrasonography showed sensitivity,
specificity, accuracy, positive predictive value, and
negative predictive value for clinical medial epicondylitis of
95.2%, 92%, 93.5%, 90.9%, and 95.8%, respectively. Tendinosis
was observed in 15 elbows, and a partial-thickness tear,
including 1 intrasubstance tear, was detected in 5 elbows. The
most common ultrasonographic abnormality was a focal echogenic
abnormality (15 hypoechoic, 5 anechoic) of the tendons.
Conclusions: Our results indicate that ultrasonography is
informative and accurate for the detection of clinical medial
epicondylitis. Therefore, ultrasonography should be considered
as an initial imaging method for evaluating medial
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