clinical features

Last edited 03/2020

The typical patient is in the fourth decade (or older) with a history of minor trauma to the elbow or repetitive activity during work or recreation (1). The classical history is of a tennis-related injury. The condition is seen often in the dominant extremity (2).

Occasionally symptoms are seen after a specific injury to the area but often the symptoms are of gradual, insidious onset (2). An abrupt onset of symptoms is uncommon (3).

  • pain
    • localized to the front of the lateral epicondyle and often radiates down the forearm (2)
    • in severe cases the pain may become more generalized
    • the pain is made worse by movements such as pouring out tea, shaking hands or lifting the wrist whilst the forearm is pronated.
  • weakness in grip strength or difficulty in carrying objects in hands (2)

On examination

  • there is no swelling
  • the elbow can be flexed and extended without pain
  • tenderness is generally localized to the lateral epicondyle over the extensor mass (2)
  • symptoms are usually reproduced with resisted supination or wrist dorsiflexion, particularly with the arm in full extension (1)
  • grip strength may be decreased (compared to the unaffected side) or may cause significant discomfort

Reference: