DipMSK Revision Guide · Chapter 5 of 18

Elbow Region Conditions

Tendinopathy of both origins, cubital tunnel, olecranon bursitis and elbow arthropathy.

Syllabus: Elbow Region Conditions

Written by Dr David Palethorpe, MBBS, BSc (Hons), MRCGP · NHS GP PartnerReviewed 14 September 202619 min readChapter 5 of 18

Before you start

Try this first

Tenderness four to five centimetres distal to the lateral epicondyle — what does that change the diagnosis to, and what else would you expect?

Radial tunnel or posterior interosseous nerve entrapment, with pain on resisted supination and resisted middle-finger extension. Tendinopathy is tender over the epicondyle itself.

2 more warm-up questions in the full chapter.

What this chapter covers

  • 5.1Lateral elbow tendinopathy (extensor origin)Insidious lateral pain provoked by gripping and twisting, with no loss of movement and no neurological or mechanical sym…Preview below
  • 5.2Medial elbow tendinopathy (flexor-pronator origin)Members
  • 5.3Cubital tunnel syndromeMembers
  • 5.4Olecranon bursitis and the septic bursaMembers
  • 5.5Degenerative and inflammatory elbow arthropathyMembers
  • —Referral, by timeframeRed flags below

Lateral elbow tendinopathy (extensor origin)

Core Lens — the takeaway

Insidious lateral pain provoked by gripping and twisting, with no loss of movement and no neurological or mechanical symptoms. Corticosteroid injection helps in the first month and is worse than placebo by six.

Recognise

  • Insidious lateral elbow pain radiating down the forearm, provoked by gripping and twisting, with tenderness over the lateral epicondyle.
  • No loss of movement, no neurological symptoms, no mechanical symptoms. If any are present it is something else.
  • Incidence 4–7 per 1,000 per year; prevalence 1–3%; two-thirds of persistent elbow pain. Men and women equally, mostly aged 35–54.

The rest of this chapter is in the DipMSK guide

4 more topics, every section opened up, the recall questions and the guidance summaries — written and reviewed by practising UK doctors.

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Referral, by timeframe

Same day · Emergency
  • Hot, swollen, systemically unwell elbow — suspected septic arthritis
  • Systemically unwell with a hot swollen elbow and severe pain on passive movement — suspected septic bursitis
  • Septic bursitis with extensive cellulitis, an abscess needing drainage, or sepsis
  • A suspected septic bursa in an immunosuppressed patient
  • Acute ulnar nerve deficit after elbow trauma
  • An adolescent with acute medial elbow pain after a throw or fall — possible epicondyle avulsion
  • A history of injury likely to have caused a fracture or dislocation

Also in the full chapter: Cancer pathway · Urgent · Routine.

← Chapter 4Shoulder Instability

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