Diagnosis of Lateral Elbow Pain
This type of elbow pain is located on the outside of the arm. There are three main diagnoses to consider in such cases. They are tennis elbow, radial tunnel syndrome, and osteochondral defects. Here’s how doctors differentiate between them and reach a diagnosis:
- Tennis elbow: This is perhaps the most common cause of lateral elbow pain. The symptoms are very similar to the golfer’s elbow, but the pain is located outside instead of inside the arm. This problem is more common in patients between 30 and 50 years, who don’t need to be tennis players to receive the diagnosis. When touching the lateral epicondyle, doctors will find tenderness 1 centimeter from this area. Doctors may also perform a maneuver to determine the strength of the arm in resisted extension, resisted wrist supination, and resisted gripping.
- Radial tunnel syndrome: Radial tunnel syndrome is sometimes mistaken for tennis elbow because it is much more common. However, many patients diagnosed with tennis elbow have this type of entrapment neuropathy. This is basically a pinched radial nerve which gives pain to the lateral side of the arm. Mechanics, carpenters, and other people who perform repetitive pronation and supination of the forearm are at a higher risk. On a physical exam, doctors will touch the area corresponding to the head of the radius, and the more intense pain is usually located here. Doctors will also perform maneuvers to detect decreased muscle strength against resisted supination of the forearm. In such cases, posterior interosseous nerve syndrome is suspected.
- Osteochondral defects: The elbow joint is formed by bones, cartilage tissue, and other soft tissue. Osteochondral defects refer to problems in the cartilage tissue. The patient’s personal history usually includes overhead throwing sports, gymnastics, and other repetitive work with the arms and forearms. The main symptom besides pain is a locked articulation that can’t be fully extended, and sometimes there’s a complete separation of an osteochondral fragment.