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Lateral elbow tendinopathy (LET) is the most common cause of elbow pain. Even though provocation tests such as Cozen's test, Mill's test or Maudsley test; musculoskeletal ultrasound or magnetic resonance imaging can be used for diagnosis, gold standard method is yet to be determined. Purpose of this study is to determine the sensitivity and specificity of clinical tests and ultrasonography in diagnosis of LET.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Lateral elbow tendinopathy | Patients with lateral epicondylitis will be included in this group. | ||
| Control | Healthy volunteers with similar demographic characteristics will be enrolled to this group. |
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| Measure | Description | Time Frame |
|---|---|---|
| Elastography | Both shear wave and strain elastography will be applied. Stiffness and shear wave velocity will be calculated on shear wave elastography and strain ratio will be calculated on strain elastography. | At enrollment |
| Measure | Description | Time Frame |
|---|---|---|
| Musculoskeletal ultrasound | Sonographic evaluation will begin with gray scale examination. Swelling, cortical irregularity, hypoechogenicity, calcification, tear common extensor tendon thickness will be assessed. Power doppler will be evaluated between the superficial fibers of the common extensor tendon, the bone surface, the insertion point of the common extensor tendon and the humeroradial joint. Doppler activity will be graded based in a 0.5-cm longitudinal part of the tendon with the maximal Doppler activity (the region of interest-ROI). The 5-point grading will be as follows. Grade 0: No activity, Grade 1: Single vessel, Grade 2: Doppler activity in 0-25% of the ROI, Grade 3: Doppler activity in 25-50% of the ROI, Grade 4: Doppler activity in >50 of ROI. Lastly elastography will be used. |
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Inclusion Criteria:
Exclusion Criteria:
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Patients presented to the outpatient clinic of Physical Medicine and Rehabilitation of Marmara University with elbow pain and diagnosed with lateral epicondylitis will be informed about the study. Willing patients will be enrolled after written consent is taken.
Control group will be chosen with volunteers, which have similar demographic characteristics.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Arda Can Kasap, M.D. | Contact | +902166254545 | drardakasap@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| İlker Yağcı, Prof. M.D. | Acıbadem Ataşehir Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Marmara University | Recruiting | Istanbul | Maltepe | 34844 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32484714 | Background | Krogh TP, Fredberg U, Ammitzboll C, Ellingsen T. Clinical Value of Ultrasonographic Assessment in Lateral Epicondylitis Versus Asymptomatic Healthy Controls. Am J Sports Med. 2020 Jul;48(8):1873-1883. doi: 10.1177/0363546520921949. Epub 2020 Jun 2. | |
| 36169174 | Background | Hong S, Hahn S, Yi J, Park EJ, Bang JY. Comparing the clinical application of strain elastography and shear wave elastography for the evaluation of lateral epicondylitis. J Clin Ultrasound. 2023 Jan;51(1):123-130. doi: 10.1002/jcu.23356. Epub 2022 Sep 28. |
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Due to legal restrictions, all data will be anonymized. Individual participant data won't be shared to third parties.
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| ID | Term |
|---|---|
| D013716 | Tennis Elbow |
| ID | Term |
|---|---|
| D000070639 | Elbow Tendinopathy |
| D052256 | Tendinopathy |
| D009135 | Muscular Diseases |
| D009140 | Musculoskeletal Diseases |
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| At enrollment |
| Cozen's test | Resisted wrist extension will be performed while patient is sitting and elbow on extension. Cozen's test will be applied to both extremities. Pain felt on the lateral epicondyle during provocation indicates a positive test result. | At enrollment |
| Maudsley's Test | Resisted third finger extension will be performed while patient is sitting and elbow on 90 degrees flexion. Maudsley's test will be applied to both extremities. Pain felt on the lateral epicondyle during provocation indicates a positive test result. | At enrollment |
| Mill's test | Maximal wrist flexion will be performed while patient is sitting, elbow on extension and forearm pronation. Mill's test will be applied to both extremities. Pain felt on the lateral epicondyle during provocation indicates a positive test result. | At enrollment |
| Hand Grip Strength | Both painless and maximum grip strength will be examined using Jamar's hand dynamometer. | At enrollment |
| Algometer | Force will be applied to lateral epicondyle using an algometer. | At enrollment |
| Patient Rated Tennis Elbow Evaluation | Patient Rated Tennis Elbow Evaluation will be used to assess pain and functional status in patients diagnosed with LET. | At enrollment |
| 33814224 | Background | Karanasios S, Korakakis V, Moutzouri M, Drakonaki E, Koci K, Pantazopoulou V, Tsepis E, Gioftsos G. Diagnostic accuracy of examination tests for lateral elbow tendinopathy (LET) - A systematic review. J Hand Ther. 2022 Oct-Dec;35(4):541-551. doi: 10.1016/j.jht.2021.02.002. Epub 2021 Feb 27. |
| D000092464 |
| Elbow Injuries |
| D001134 | Arm Injuries |
| D014947 | Wounds and Injuries |
| D013708 | Tendon Injuries |