2. Intro:
• Not an inflammatory condition
• Tendinosis that affects the common attachment of
tendons of extensor muscles of forearm( esp. ECRB)
• 1ST described by F.Runga in 1873
• Nirschl described angiofibroblastic tendinosis
3. Etiology
• Any activity that involves overuse of wrist extensors or
supinator muscles
• Popularly associated while playing tennis
• Goldie attributed the onset of symptoms to overexertion of
the extremity with repetitive wrist extension & alternating
forearm pronation or supination.
• Smidt & van der Windt identified factors that can be avoided
to relieve symptoms.
4. Associations
• Nirschl described mesenchymal syndrome suggesting a genetic
linkage to the development of the disease.
• Tennis elbow pts tend to have higher incidence of RF & HLA-27 +ve
• Not proved etiopath – Synovial fringe inflammation ( Trethwan)
- ECRB tear ( Cyriax)
- Radial nerve neuritis ( Kaplan)
- Radial nerve entrapment ( Roles & Maudsley)
- Radial head fibrillation ( Newman & Goodfellow)
- Anconeus inflammation ( Coe et al)
10. Surgical
• Partial resection of annular ligament of Bosworth
• Distal lengthening of ECRB of Garden
Arthroscopic Mx – 1st described by Grifka, Boenke & Kramer in 1995
Percutaneous release – extensor slide or Hohmann’s epicondylar
stripping procedure
Rx failures was divided into 2 types by Morrey.