Lateral epicondylitis vs Medial epicondylitis
How to tell Lateral epicondylitis and Medial epicondylitis apart when a board question makes them look alike.
Lateral epicondylitis is extensor pain with resisted wrist extension; medial epicondylitis is flexor-pronator pain with resisted wrist flexion.
Side by side
Lateral epicondylitis causes lateral elbow pain from common extensor tendon overuse, worse with resisted wrist extension or gripping.
Medial epicondylitis causes medial elbow pain from common flexor-pronator tendon overuse, worse with resisted wrist flexion or pronation.
Repetitive wrist extension and gripping injure the extensor carpi radialis brevis origin.
Repetitive wrist flexion and pronation injure the common flexor tendon origin.
Tender lateral epicondyle and pain with resisted wrist extension support lateral epicondylitis.
Tender medial epicondyle and pain with resisted wrist flexion/pronation support medial epicondylitis.
The trap
Both are overuse elbow tendinopathies, so side of elbow and provocative wrist motion separate them.
The repair move
For epicondylitis, map elbow side to wrist extensor versus flexor-pronator loading.
Try a free question
CoreA 44-year-old recreational tennis player has 3 months of pain at the lateral aspect of the right elbow, reproduced by resisted wrist extension and gripping. Tenderness is maximal over the lateral epicondyle at the common extensor tendon origin. Which diagnosis is most likely?
Show answer and explanation
Answer: A. Lateral epicondylitis (tennis elbow). Lateral epicondylitis (tennis elbow) is overuse tendinopathy of the common extensor tendon origin, with pain reproduced by resisted wrist extension and tenderness over the lateral epicondyle.
Why the other choices are tempting
- B. Medial epicondylitis (golfer's elbow) affects the flexor-pronator tendon at the medial epicondyle with pain on resisted wrist flexion.
- C. Olecranon bursitis presents as a posterior elbow swelling, often after trauma or with crystal disease.
- D. Cubital tunnel syndrome is ulnar nerve compression with medial elbow symptoms and small finger numbness.
- E. Radial tunnel syndrome causes lateral forearm pain with negative resisted extension testing.
Flashcards
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What motion worsens lateral epicondylitis?
Resisted wrist extension worsens lateral epicondylitis.
What motion worsens medial epicondylitis?
Resisted wrist flexion or pronation worsens medial epicondylitis.
Quick answers
What is the fastest way to tell Lateral epicondylitis from Medial epicondylitis?
Lateral epicondylitis is extensor pain with resisted wrist extension; medial epicondylitis is flexor-pronator pain with resisted wrist flexion.
What is the key clue for Lateral epicondylitis?
Lateral epicondylitis causes lateral elbow pain from common extensor tendon overuse, worse with resisted wrist extension or gripping.
What is the key clue for Medial epicondylitis?
Medial epicondylitis causes medial elbow pain from common flexor-pronator tendon overuse, worse with resisted wrist flexion or pronation.
What is the common trap with Lateral epicondylitis vs Medial epicondylitis?
Both are overuse elbow tendinopathies, so side of elbow and provocative wrist motion separate them.