4.8 Article

Lateral Epicondylitis

Journal

NEW ENGLAND JOURNAL OF MEDICINE
Volume 388, Issue 25, Pages 2371-2377

Publisher

MASSACHUSETTS MEDICAL SOC
DOI: 10.1056/NEJMcp2216734

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A 44-year-old healthy man with a 3-month history of right lateral elbow pain presents without a history of trauma. He experiences pain when using his arm, especially with lifting, even with light objects. Physical examination reveals point tenderness over the lateral epicondyle and pain with resisted wrist extension. Other examinations are normal.
A 44-year-old otherwise healthy man presents with a 3-month history of right lateral elbow pain without a history of trauma. The arm aches when he uses it, especially with lifting, even when lifting light objects such as a coffee cup. He works as a computer programmer and notes pain with picking up his laptop but not with typing. On physical examination, there is point tenderness over the lateral epicondyle at the elbow and pain with resisted wrist extension. There is no tenderness over the forearm, posterior elbow, or medial elbow, and he has full range of motion of the joint. A sensory examination, including provocative testing for ulnar-nerve compression with elbow flexion and tapping over the ulnar nerve just below the medial epicondyle, is normal. How should the patient be evaluated and treated?

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