Elbow – Epicondylitis

CASE HISTORY

47-year-old female with elbow pain distal biceps tendinitis clinically and tennis elbow clinically for six months. Clinical concern for common extensor tendon tear.

TECHNICAL FACTORS

Axial and coronal T1 and T2 weighted imaging was performed along with sagittal T1 weighted imaging.

KEY IMAGES

This case has no key images.

CASE FINDINGS

• The brachialis and triceps tendons are intact. Low-grade distal biceps tendinosis/strain present decreased in severity compared to the prior exam. There is no distal biceps tendon tear. Small amount of elbow joint effusion present. 
• Subcentimeter subcortical pseudocyst is again noted at the capitellum and lying immediately anterior/ventral to the capitellar pseudodefect. Hypertrophic common extensor origin tendinosis/strain present with few thin interstitial tears. Common extensor peritendinitis also present with overlying lateral/radial elbow subcutaneous soft tissue edema. There is also a small area of moderate-grade strain/edema of the nearby proximal flexor digitorum superficialis muscle. Low-grade swelling/sprain of the underlying RCL complex present without tear. 
• The common flexor tendon origin and underlying UCL complex are intact. The course of the ulnar nerve in the cubital tunnel is normal.

CASE CONCLUSION

• Hypertrophic common extensor origin tendinosis/strain with few small interstitial tears. Surrounding soft tissue swelling. 
• Strain of the nearby proximal FDS muscle. Intact RCL complex. 
• Joint effusion. 
• Low-grade distal biceps tendinosis decreased in severity compared to prior exam. No distal biceps tendon tear.