J Korean Orthop Assoc.  2009 Oct;44(5):542-547. 10.4055/jkoa.2009.44.5.542.

Ultrasonographic Measurement of Thickness of Extensor Carpai Radialis Brevis Tendons for Lateral Epicondylitis

• Kim BS
• Min GD
• Cha JG
• Lee JS

• KMID: 2186314
• DOI: http://doi.org/10.4055/jkoa.2009.44.5.542

Abstract

PURPOSE
To evaluate the ultrasonographic measurements of the thickness of the extensor carpai radialis brevis tendons in patients with lateral epicondylitis. MATERIALS AND METHODS: Twenty nine patients diagnosed with lateral epicondylitis were examined prospectively. Eight were male and twenty one were female. The mean age was 48 (34-62) years. The average time from the onset of symptoms until the examination was 9 (1-24) months. Eighteen patients did not show improvement in their symptoms after conservative treatment. Six underwent arthroscopic debridement and 4 underwent electric shock wave therapy. Three patients showed calcification on the simple x-ray. The thickness of the extensor carpai radialis brevis tendons on both the lesion and contralateral sides was measured and compared using ultrasonography. RESULTS: There were no significant differences in age and gender between the thickness of the extensor carpai radialis brevis tendons on the lesion and contralateral sides (p=0.83, 0.25, 0.80, 0.64). The thickness of the extensor carpai radialis brevis tendons on the lesion and contralateral sides were 4.9 mm and 3.2 mm, respectively, and the lesion side was significantly thicker (p<0.001). The best cut off value of the ECRB thickness at its origin was 3.95 mm, which had a sensitivity, specificity and accuracy of 96.6%, 79.3% and 87.9%, respectively. CONCLUSION: Sonographic measurements of the thickness of the ECRB tendons are valuable for diagnosing lateral epicondylitis.

Keyword

Elbow; Lateral epicondylitis; Ultrasonography

MeSH Terms

Debridement
Elbow
Female
Humans
Male
Prospective Studies
Sensitivity and Specificity
Shock
Tendons

Figure

• 

  Fig. 1 Receiver operation characteristic curve fitted for sonography as the reference standard. The area under the curve was 0.88 (95% CI, 0.79-0.97).

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  Fig. 2 A transverse image of extensor carpi radialis brevis tendon of symptomatic 49-year-old man with lateral epicondylitis is shown. The tendon of lesion (left) side is more thickened measuring 0.54 cm than contralateral (right) side measuring 0.31 cm. The ECRB origin (diamond shape area between midline of the radiocapitella joint and top of the capitellum) and scan area (black arrow, oval) for measurement are shown.

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