Common extensor tendon

Abstract: Tendon injuries can be divided into several categories on the basis of the nature of their onset and the tissues involved. Acute tendon injuries, such as laceration of the flexor tendons of the fingers, are traumatic in nature. Chronic overuse injuries are the result of multiple microtraumatic events that cause disruption of the internal structure of the tendon and degeneration of the cells and matrix, which fail to mature into normal tendon; at times, such injuries result in tendinosis35. The healing of acute tendon injuries has been studied from the perspective of the body's response to lacerations of flexor tendons as well as after operative intervention35,67. Tendinosis is incompletely understood. Although the term tendinitis is used frequently and often indiscriminately, histopathological studies have shown that specimens of tendon obtained from areas of chronic overuse do not contain large numbers of macrophages, lymphocytes, or neutrophils26,35,59. Rather, tendinosis appears to be a degenerative process that is characterized by the presence of dense populations of fibroblasts, vascular hyperplasia, and disorganized collagen. This constellation of findings has been termed angiofibroblastic hyperplasia48. It is not clear why tendinosis is painful, given the absence of acute inflammatory cells, nor is it known why the collagen fails to mature. If it can be assumed that tendinosis has essentially the same pathogenesis regardless of where it occurs in the body, then the examination of specimens from patients who have tennis elbow can serve as a model for the investigation of pain in other regions in which tendinosis has been reported, such as the rotator cuff, the Achilles tendon, the patellar ligament, the adductors of the hip, the triceps, the flexors and extensors of the elbow, and the plantar fascia7,26,27 …

Abstract: In a series of 1,000 patients with tennis elbow or medial or lateral epicondylitis, adequate follow-up was obtained on 339 patients. Of these, 278 responded to conservative therapy and thirty-nine were operated on. Tears of the extensor or flexor tendon were seen in twenty-eight patients. Resection of the torn or scarred portion of the tendon and suture, if feasible, gave generally satisfactory results.

Abstract: OBJECTIVE. The purpose of this study was to describe the sonographic appearance of the common extensor origin in cadavers and asymptomatic volunteers, and to relate this appearance to the findings in patients with lateral epicondylitis.SUBJECTS AND METHODS. Seventy-two elbows in 71 patients with lateral epicondylitis were examined on sonography. Most of the patients (60/71) gave a history of repetitive microtrauma. The injuries were evaluated with respect to location and severity. Focal areas of degeneration, discrete cleavage tears, and involvement of the lateral collateral ligament were identified. Calcification and bony changes were noted. The appearance of the normal common extensor tendon was described, and cadaveric specimens were dissected. Twenty-one patients subsequently underwent surgery.RESULTS. The normal common extensor origin is composed of longitudinal fibrils bound closely with the extensor carpi radialis brevis constituting most of the deep fibers, with the extensor digitorum making up th...

Abstract: PURPOSE: To determine the sensitivity and specificity of ultrasonography (US) in the detection of lateral epicondylitis and identify the US findings that are most strongly associated with symptoms. MATERIALS AND METHODS: Internal review board approval was obtained for retrospective review of the patient images, and the need for informed consent was waived. Internal review board approval was also obtained for scanning the 10 volunteers, all of whom gave informed consent. The study was compliant with the Health Insurance Portability and Accountability Act. US of the common extensor tendon was performed in 20 elbows in 10 asymptomatic volunteers (six men, four women; age range, 22–38 years; mean age, 29.6 years) and 37 elbows in 22 patients with symptoms of lateral epicondylitis (10 men, 12 women; age range, 30–59 years; mean age, 46 years). Fifty-seven representative images, one from each elbow, were randomly assorted and interpreted by three independent readers who rated each common extensor tendon as norm...