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Magnetic resonance imaging evaluation of patients with clinically diagnosed medial Epicondylitis

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Abstract

Objective

We evaluated magnetic resonance imaging (MRI) findings in patients with clinically diagnosed medial epicondylitis (ME) and determined whether any of the MRI findings correlated with the follow-up pain level after nonoperative treatment.

Materials and methods

We retrospectively reviewed 83 patients who had undergone elbow MRI examinations for clinically diagnosed ME and who were followed-up for more than 6 months. Five categories of MRI findings were selected for qualitative grading: common flexor tendon (CFT) origin signal changes, ulnar collateral ligament (UCL) insufficiency, ulnar neuritis, bony changes of the medial epicondyle, and calcification. The mean follow-up after MRI examination was 21 months. We performed multivariate regression analysis to analyze whether any of these MRI findings were associated with the follow-up pain level after nonoperative treatment.

Results

Positive MRI findings included CFT origin signal changes (66%), ulnar neuritis (40%), UCL insufficiency (30%), calcification (27%), and bony changes (18%). Multivariate analysis indicated that CFT origin signal changes were independently associated with the follow-up pain level (β = 3.387; p = 0.004).

Conclusion

In patients with clinically diagnosed ME, MRI demonstrated diverse abnormal findings in the CFT origin, ulnar collateral ligament, ulnar nerve, and bone. Among the findings, the severity CFT origin signal changes, which indicates the severity of tendon degeneration in ME, was associated with the follow-up pain level. This information can be helpful in consulting on the prognosis of nonoperative treatment in patients with clinically diagnosed ME.

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Author information

Author notes

  1. Kee Jeong Bae and Chulhee Park contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopedic Surgery, Seoul National University Boramae Medical Center, Seoul, South Korea

    Kee Jeong Bae

  2. Department of Orthopedic Surgery, Armed Forces Capital Hospital, Seongnam, South Korea

    Chulhee Park

  3. Department of Radiology, Seoul National University Bundang Hospital, Seongnam, South Korea

    Joong Mo Ahn & Yusuhn Kang

  4. Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Gyeonggi-do, Seongnam-si, 463-707, South Korea

    Hyun Sik Gong

Authors
  1. Kee Jeong Bae
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  2. Chulhee Park
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  3. Joong Mo Ahn
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  4. Yusuhn Kang
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  5. Hyun Sik Gong
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Corresponding author

Correspondence to Hyun Sik Gong.

Ethics declarations

This study was approved by the Institutional Review Board of the authors’ hospital (Seoul National University Bundang Hospital IRB No: B-1712/436–110). All investigations were conducted in accordance with the ethical standards of the institutional research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Informed consent was obtained from all participants.

Conflict of interest

This study was not funded by any project or group. Each author certifies that he or she has neither financial nor nonfinancial potential conflicts of interest regarding the research, authorship, and/or publication of this study.

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Level of Evidence: Level IV, Diagnostic Study

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Bae, K.J., Park, C., Ahn, J.M. et al. Magnetic resonance imaging evaluation of patients with clinically diagnosed medial Epicondylitis. Skeletal Radiol 50, 1629–1636 (2021). https://doi.org/10.1007/s00256-021-03720-z

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  • DOI: https://doi.org/10.1007/s00256-021-03720-z

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