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The forearm muscles coordinately control wrist motion, and their activity is affected by forearm rotation. Although forearm rotation has been implicated in the development of lateral and medial epicondylitis, its biomechanical background remains unknown. Therefore, the present study investigated the activity of wrist muscles in various forearm positions. Surface electromyography of the extensor carpi radialis brevis, extensor carpi ulnaris, flexor carpi radialis, and flexor carpi ulnaris was performed on 40 healthy upper limbs. We initially measured muscle strength and electromyographic activity (integrated electromyographic value per second) at maximum voluntary output towards wrist extension and flexion in a neutral position. We then assessed electromyographic activity under constant wrist torque (75% of maximum strength in the neutral position) in pronation, the neutral position, and supination. The percentage of maximum electromyographic activity was evaluated for each position. In wrist extension, the extensor carpi radialis brevis was activated during forearm pronation, while extensor carpi ulnaris activity did not change in any forearm position. In wrist flexion, the flexor carpi radialis was activated during forearm supination, while flexor carpi ulnaris activity was significantly lower with forearm pronation than in the neutral position. Since muscle activation increases traction force at the tendon origin, forearm positions that increase muscle activity may be a biomechanical risk factor for the development of tendinopathy. The present results are consistent with epidemiological and pathological findings on lateral and medial epicondylitis. These results provide insights into wrist biomechanics and the pathophysiology of lateral and medial epicondylitis. [ABSTRACT FROM AUTHOR]

Introduction: Medial epicondylitis, or golfer's elbow, is caused by repetitive stress on the medial epicondyle tendons, leading to pain, reduced grip strength, and limited mobility. Poor biomechanics and overloading worsen the condition, which involves tendon degeneration and inflammation. Treatment begins with rest, physical therapy, and NSAIDs, while advanced cases may require injections, surgery, or innovative therapies targeting oxidative stress. Aim of study Objective: The objective of this paper is to analyze the causes, symptoms, and available treatment n methods for golfer's elbow (medial epicondylitis). The paper aims to compare the effectiveness of conservative methods and surgical interventions in treating this condition, as well as discuss the latest advancements in therapy State of Knowledge: Medial epicondylitis, or golfer's elbow, is a chronic tendon condition caused by repetitive stress. Diagnosis relies on clinical evaluation and imaging, while treatment begins with conservative methods like rest and physical therapy. For resistant cases, surgical options and innovative therapies. A multimodal, personalized approach ensures optimal recovery and long-term relief. Summary (Conclusion): Medial epicondylitis, or golfer's elbow, is caused by repetitive stress and degenerative changes in the flexor-pronator tendons. Effective diagnosis combines clinical evaluation and imaging. Conservative treatment, including rest, physical therapy, and pharmacological support, is the first-line approach. In refractory cases, surgical options like open repair and arthroscopy, along with innovative techniques such as collagen-augmented sutures and stem cell applications, show promising results. Complementary therapies, such as ESWT, PRP, and manual therapy, further enhance outcomes, particularly in chronic cases. A multimodal, personalized approach ensures optimal tendon healing, functional recovery, and long-term symptom relief.

There are a number of factors that can contribute to the exacerbation of tendinopathies around the elbow. In order to effectively manage patients, it is important to understand the natural progression of these conditions, injury mechanisms, potential risk factors and the range of pathological manifestations. Presently, disease-modifying treatments for tendinopathy are lacking, placing non-operative approaches, staged physiotherapy and support at the forefront of primary options. Conservative management proves successful for medial and lateral epicondylitis, though some cases may require up to a year for improvement. Short-term relief can be achieved with non-steroidal anti-inflammatory drugs and corticosteroid injections, although their long-term efficacy is uncertain, and evidence for alternative injection therapies is limited. Surgical intervention can be considered if non-operative management proves ineffective after 6–12 months, often involving open resection, debridement, and repair. While arthroscopic techniques offer promise, they present inherent risks, particularly in patients with prior surgeries. Despite the rarity of distal triceps and biceps tendinopathies, prompt diagnosis and non-operative approaches are pivotal, with surgery considered if symptoms persist after 6 months. Overall, favourable outcomes can be achieved for common elbow tendinopathies with control of risk factors and appropriate care. [ABSTRACT FROM AUTHOR]

Background: This case series aimed to introduce surgical management for refractory medial epicondylitis based on the anatomical characteristics of the flexor pronator origin and present the surgical results. Methods: Ten elbows from 8 patients (2 males and 6 females; mean age 50.2 years) were included in this case series. All patients underwent resection of the degenerated anterior common tendon and repair using suture anchors. Ulnar neuritis was observed in 9 elbows of 7 patients who underwent the relevant additional surgery. Results: Medial elbow pain was resolved in all patients, and pain provocation tests (wrist flexion test and forearm pronation test) were negative postoperatively. The mean Patient-Rated Elbow Evaluation (Japanese version) score was significantly improved from 79.6 ± 7.7 (range, 64.3-92) preoperatively to 8.4 ± 15.2 (range, 0-50) at the final follow-up. Conclusion: Angiofibroblastic tendinosis of the anterior common tendon might be an essential pathology of medial epicondylitis, and anterior common tendon resection and repair could be the most appropriate treatment for medial epicondylitis.

The existing literature has explored carpal tunnel syndrome (CTS) and determined that it could be a risk for coronary artery disease (CAD), but there has been little research comparing the relevance of CAD with other neuromuscular disorders (NMDs) to CTS. This case–control study explored the association between CTS, stenosing tenosynovitis (ST), and ulnar side NMDs and CAD. The study utilized data from Taiwan's National Health Insurance Research Database, focusing on health insurance claims. Between January 2000 and December 2011, we employed the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic codes to identify 64,025 CAD patients as the case group. The control group consisted of an equal number of individuals without CAD, matched for age, sex, and index year of CAD. Logistic regression analysis was employed to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for each variable. Multivariate analysis, after adjusting for sociodemographic factors and comorbidities, revealed a significantly higher likelihood of a previous diagnosis of CTS in the CAD group compared to the comparison control group. However, neither ST nor the ulnar side NMDs had any statistical significance. These results indicated that median nerve injury, rather than other NMDs, may uniquely serve as a predisposing factor of CAD. [ABSTRACT FROM AUTHOR]

Background: Elbow pain is common among youth baseball players and elbow MRI is increasingly utilized to complement the clinical assessment. Objective: To characterize, according to skeletal maturity, findings on elbow MRI from symptomatic youth baseball players. Materials and methods: This IRB-approved, HIPAA-compliant retrospective study included pediatric (<18 years of age) baseball players with elbow pain who underwent MRI examinations between 2010 and 2021. Two radiologists, blinded to the outcome, independently reviewed examinations to categorize skeletal maturity and to identify osseous and soft tissue findings with consensus used to resolve discrepancies. Findings were compared between skeletally immature and mature patients and logistic regression models identified predictors of surgery. Results: This study included 130 children (115 boys, 15 girls): 85 skeletally immature and 45 mature (12.8±2.3 and 16.2±1.0 years, respectively, p<0.01). Kappa coefficient for interobserver agreement on MRI findings ranged from 0.64 to 0.96. Skeletally immature children, when compared to mature children, were more likely to have elbow effusion (27%, 23/85 vs 9%, 4/45; p=0.03), medial epicondyle marrow edema (53%, 45/85 vs 16%, 7/45; p<0.01), avulsion fracture (19%, 16/85 vs 2%, 1/45; p=0.02), and juvenile osteochondritis dissecans (OCD, 22%, 19/85 vs 7%, 3/45; p=0.04), whereas skeletally mature children were more likely to have sublime tubercle marrow edema (49%, 22/45 vs 11%, 9/85; p<0.01) and triceps tendinosis (40%, 18/45 vs 20%, 17/85; p=0.03). Intra-articular body (OR=4.2, 95% CI 1.5–47.8, p=0.02) and osteochondritis dissecans (OR=3.7, 95% CI 1.1–11.9, p=0.03) were independent predictors for surgery. Conclusion: Differential patterns of elbow MRI findings were observed among symptomatic pediatric baseball players based on regional skeletal maturity. Intra-articular body and osteochondritis dissecans were independent predictors of surgery. [ABSTRACT FROM AUTHOR]

Objective Lateral and medial epicondylitis are relatively common diseases, but they do not improve quickly and are known to reduce patients' quality of life. Much research has been done on Platelet‐Rich Plasma (PRP) as a treatment for lateral epicondylitis, but research on medial epicondylitis is lacking. The purpose of this study is to compare: (i) the pain intensity; and (ii) the functional outcome between the simultaneous treatment of medial and lateral epicondylitis and the treatment of only lateral or medial epicondylitis using PRP. Methods In this retrospective study, 209 patients treated with PRP on epicondylitis between March 2018 and December 2021 were enrolled. Simultaneous treatment was underwent 68 patients (group I). Seventy patients were treated for lateral epicondylitis (group II). The remaining 71 patients were treated for medial epicondylitis (group III). The visual analogue scale for pain (VAS) and the Mayo elbow performance score (MEPS) were evaluated for clinical outcomes at the initial visit and 6 months after injection. Results VAS for pain and MEPS showed significant improvement in all three groups compared to before treatment. There was no significant difference between three groups on –ΔVAS (P > 0.05). However, in case of ΔMEPS, group III showed significantly lower compared to groups II and III (P

Background One of the most common reasons of patients’ visits with complaints in the area of the elbow joint is epicondylitis of the elbow joint. Surgical treatment is recommended if conservative treatment fails after 6-12 months. Arthroscopy of the elbow joint is one of the current surgical methods of minimally invasive interventions on the elbow joint. Purpose To conduct a comparative assessment of the effectiveness of treating epicondylitis of the elbow joint using modified arthroscopic and open techniques Methods A prospective cohort-controlled study was performed on 120 patients. The patients were divided into two groups: group 1 – patients operated on by the open method (control), group 2 – patients operated on by the arthroscopic method. Additionally, depending on the nosology, the patients were divided into four subgroups. Functional results were assessed using VAS, DASH, MEPS; additionally, dynamometry was performed before surgery, and 1, 3 and 12 months after surgery. Results There is a significant improvement in the function of the elbow joint one month after surgical treatment, mainly in III and IV subgroups according to the MEPS scale, p = 0.0001. According to the VAS scale, a pronounced and persistent decrease in pain in the long-term period compared with the preoperative period was revealed in patients of the arthroscopic subgroup p = 0.0001. According to the DASH questionnaire, the functional results in patients of arthroscopic group in the postoperative period significantly exceeded over the open method p < 0.001. Discussion The use of the open surgical method provides good or excellent functional outcomes of treatment in 75-85 %. However, it has a number of disadvantages, including infectious complications and the inability of the surgeon to identify and completely remove the pathological altered tissues. The arthroscopic technique allows leveling these shortcomings and obtaining up to 95‑100 % excellent functional results. Conclusion Based on the data obtained in this study, the reatment of patients with epicondylitis of the distal humerus according to the developed arthroscopic technique significantly improves the functional state of patients, which, in turn, improves their quality of life.

Objective: Lateral and medial epicondylitis are relatively common diseases, but they do not improve quickly and are known to reduce patients' quality of life. Much research has been done on Platelet‐Rich Plasma (PRP) as a treatment for lateral epicondylitis, but research on medial epicondylitis is lacking. The purpose of this study is to compare: (i) the pain intensity; and (ii) the functional outcome between the simultaneous treatment of medial and lateral epicondylitis and the treatment of only lateral or medial epicondylitis using PRP. Methods: In this retrospective study, 209 patients treated with PRP on epicondylitis between March 2018 and December 2021 were enrolled. Simultaneous treatment was underwent 68 patients (group I). Seventy patients were treated for lateral epicondylitis (group II). The remaining 71 patients were treated for medial epicondylitis (group III). The visual analogue scale for pain (VAS) and the Mayo elbow performance score (MEPS) were evaluated for clinical outcomes at the initial visit and 6 months after injection. Results: VAS for pain and MEPS showed significant improvement in all three groups compared to before treatment. There was no significant difference between three groups on –ΔVAS (P > 0.05). However, in case of ΔMEPS, group III showed significantly lower compared to groups II and III (P < 0.05). No patients showed worsening of symptoms or complications during the treatment. Conclusion: PRP injection for the patient with elbow medial and lateral epicondylitis can be treated effectively simultaneously in terms of pain. From a functional point of view, the effect of simultaneous treatment may be lessened than in the case of only lateral and medial treatment. [ABSTRACT FROM AUTHOR]

Background: Medial epicondylitis (ME) is a pathological condition that arises in laborers and athletes secondary to repetitive wrist flexion and forearm pronation causing degeneration of the common flexor tendon. Although nonoperative management has demonstrated high rates of success, no standardized surgical technique has been established for situations when operative management is indicated. Purpose/Hypothesis: The purpose of this study was to perform a systematic review of the surgical treatment options for ME and evaluate the associated patient-reported outcomes (PROs). We hypothesized that surgical management of ME would vary across studies but no technique would prove to be superior. Study Design: Systematic review; Level of evidence, 4. Methods: Searches were conducted using PubMed, EMBASE, Cumulative Index of Nursing Allied Health Literature (CINAHL), SPORTDiscus, and Cochrane databases between 1980 and April 2020. All level 1 to 4 studies were identified that focused on surgical management and PROs in the setting of ME. Description of surgical technique and PROs were required for inclusion. Investigators independently dually abstracted and reviewed the studies for eligibility. Weighted means were calculated for demographic characteristics and available PROs. Results: Overall, 851 studies were identified according to the search criteria. A total of 16 studies met the inclusion and exclusion criteria and therefore were evaluated. Three surgical techniques were found: open (13 studies), arthroscopic (2 studies), and percutaneous (1 study). Descriptions of the open technique were subdivided into those with (7 studies) and without (6 studies) common flexor tendon repair. Analysis included 479 elbows; patients were primarily male (58.3%) with a weighted mean age of 47.2 years. Weighted mean follow-up was 4.6 years. Tennis and manual laborer were the most common sport and occupation, respectively. Surgical success ranged from 63% to 100%, with a low complication rate of 4.3%. Success rates for return to sports and work were 81%-100% and 66.7%-100%, respectively, and only 1 study reported a return to work rate <90%. Conclusion: This systematic review demonstrates that surgical intervention for refractory ME often has a high success rate. Regardless of surgical technique performed, patients generally demonstrated an improvement in PROs, and an encouraging number returned to work with limited complications. Further investigation is necessary to determine superiority among open, arthroscopic, and percutaneous techniques. [ABSTRACT FROM AUTHOR]

Background. Arthroscopic methods of diagnosis and treatment of elbow diseases have not yet become widespread due to the small volume of the joint, the close location to neurovascular bundles and the manipulation difficulty. The aim of the study was to determine the safe zones for the minimally invasive approaches to the elbow in patients with lateral and medial epicondylitis. Methods. A complex anatomical and clinical study was performed. The anatomical part was carried out on 30 non-fixed anatomical preparations of the upper limb. The features of the tendon-muscular and neurovascular structures surrounding the elbow were studied, depending on the angle of elbow flexion at three different levels: level I 5 cm above the articular gap, level II the articular gap, level III the neck of the radius. In the clinical part of the study, the these structures were studied by MRI in 30 patients. Results. The brachial artery at the level I is located from the bone at a distance 28.6 (28.4-28.7) mm at the elbow flexion to 90. The radial nerve at level II is located at a distance of 15.8 (15.6-16.0) mm from the nominal medial epicondylar line (NMEL). From the NMEL the median nerve is located at a distance of 17.5 (16.6-18.1) mm, the brachial artery 22.4 (20.5-22.8) mm. The anterior bundle of the medial collateral ligament has the following average width throughout: the proximal part 6.21.4 mm; the middle part 6.51.5 mm; the distal part 9.31.4 mm. The average area of the medial collateral ligament attachment to the medial condyle of the humerus was 45.59.3 mm2 and has a rounded shape. The average length of the radial collateral ligament was 20.51.9 mm; width 5.20.8 mm, the average area of its attachment to the humerus was 13.61.4 mm2. The average area of the extensor carpi radialis brevis on the lateral condyle of the humerus was 53.13.7 mm2. The average distance from the entrance of the deep branch of the radial nerve into the supinator canal to the articular gap 28 (25.5-29.6) mm. Conclusion. The results of the study make it possible to choose the safe arthroscopic approaches to the elbow with minimal risk of damage to neurovascular structures in the treatment of patients with lateral and medial epicondylitis.

Introduction and Purpose: Tennis elbow and golfer's elbow are two stress syndromes of the elbow joint region which have received much attention due to their effects on everyday and sporting activities. This review intends to provide an up-to-date summary of the pathophysiology, clinical manifestation, diagnostic techniques, and treatment options for the two conditions. State of Knowledge: Recent research has emphasized the complexity of these diseases, connecting various causes to their emergence. The current study also shows how inflammation, tendon degradation, and neural involvement contribute to these disorders. Imaging advancements, such as ultrasound and MRI, have improved the diagnostic process by allowing visualization and recognition of underlying disorders. To ensure proper management, differential diagnoses, such as nerve compression syndromes and other musculoskeletal diseases, must be carefully evaluated. Rest, physiotherapy, NSAIDs, and corticosteroid injections are important first-line treatments. Novel therapeutic interventions, such as PRP therapy and ESWT have recently been studied as supplements or alternatives to traditional procedures. The exercise-based rehabilitation in controlling and preventing recurrence is also emphasized. Although surgery is reserved for the most difficult cases, advances in minimally invasive techniques have resulted in better outcomes. Conclusion: Recent literature has significantly contributed to our understanding of elbow stress syndromes. The synthesis of recent research provides clinicians with valuable insights into optimal management strategies. Although, further research is crucial to improve diagnosis, develop new treatments, and raise the standard of care for those affected by these conditions.

Introduction: While commonly referred to as “golfer's elbow,” medial epicondylitis (ME) is a syndrome that more frequently presents in overhead throwing athletes and manual laborers. Repeated eccentric loading of the common flexor tendon attachment to the medial epicondyle leads to a spectrum of inflammation, microtrauma, and degeneration. Ulnar neuritis may be present in up to 60% of patients with ME, and its identification is imperative as up to 63% of these patients will experience persistent neurological symptoms. This review sought to provide a comprehensive reference for the current management of ME. Treatment and outcomes: Conservative management remains the mainstay for ME, with up to 85–95% of patients responding to initial treatment. Possible combinations for conservative treatment include trials of topical and/or oral NSAIDs, physical therapy, reduced activity levels, corticosteroid injections, electrical stimulation, and iontophoresis. Despite initial response to therapy, many patients experience symptom recurrence and progress to surgical intervention. Operative interventions include a variety of open, percutaneous, and arthroscopic approaches, with technique selection depending on patient presentation as well as physician experience and preference. Novel interventions for refractory ME treatment include injections of neutrophil-reduced platelet-rich plasma, and transcatheter arterial embolization. Bone marrow aspirate injections have also demonstrated some success in patients with lateral epicondylitis, but this modality has not yet been studied in ME to date. Conclusions: While less frequently encountered when compared to other upper extremity pathologies, ME remains a clinically important topic due to the prevalence of refractory cases and the constantly evolving treatment possibilities for the condition.

Medial epicondylalgia is a repetitive stress condition. The aim of this study was to assess whether Kinesio taping offers any superiority over athletic taping for chronic medial epicondylalgia management. The results show statistically significant differences in isokinetic and patient self-reported variables between each group: (a) Group A: Kinesio tape with rehabilitation: (b) Group B: athletic taping with rehabilitation: and (c) group C: only rehabilitation. Although no significant differences in preintentervention group assessments (p > .05) were found, only Group (A) showed statistically significant posttreatment improvements. Kinesio taping over athletic taping appears effective for treating chronic medial epicondylalgia and facilitating pain reduction and isokinetic improvements. [ABSTRACT FROM AUTHOR]

This retrospective study compared the outcomes after open and arthroscopic treatment of chronic medial epicondylitis (ME). The study included 44 elbows in 38 patients: 25 (29-72 years) in the open group and 19 (27-70 years) in the arthroscopy group. The indications for ME surgery were failed conservative therapy for more than 3 months, symptom duration exceeding 6 months, and persistent severe pain. We used radiography, ultrasonography, and magnetic resonance imaging assessments. The clinical assessment included operating time, range of motion, grip strength, visual analog scale (VAS) score, Disabilities of the Arm, Shoulder, and Hand (DASH) score, and complications. The mean follow-up was 20.2 (12-58) months. The mean operating time was significantly longer in the arthroscopy group (32.5 vs. 23.5 minutes; P =.029). In both groups, all outcome measures improved significantly after surgery and there were no significant differences between the DASH scores (preoperative 44.8 vs. 43.9, postoperative 12.5 vs. 13.2), grip strength (preoperative 72.2 vs. 66.8, postoperative 84.8 vs. 83.6), and VAS scores (preoperative 8.5 vs. 8.2, postoperative 1.0 vs. 1.1) in the open and arthroscopy groups. The outcomes were excellent or good in 20 patients (80%) in the open group and 16 (84%) in the arthroscopy group. The only complication was 1 case of transient ulnar neuropathy in the open group. Open and arthroscopic techniques were very effective and comparable for treating chronic ME. The surgeon can choose either technique for treating chronic ME. [ABSTRACT FROM AUTHOR]

Purpose: Medial epicondylitis is a tendinosis found commonly in throwing and golfing athletes. Although there are choices for nonsurgical treatments, when these fail, surgical intervention can be considered. When surgical treatment is performed, the objective is to debride the diseased tissue from the epicondyle. The purpose of this study was to clarify the locations and size of the common flexor tendons and medial collateral ligament (MCL) relative to each other and to the posterior ridge of the medial epicondyle., Methods: The common flexor tendons and MCL were dissected and reflected their origin on the medial epicondyle in six cadaver elbows. Measurements were taken from the posterior and distal ridges of the medial epicondyle with respect to the humerus. Each origin was also measured for its height and width., Results: The flexor carpi ulnaris origin starts at a mean of 4.2 mm from the posterior ridge of the medial epicondyle and extends anteriorly an average of 4.8 mm. The flexor carpi radialis starts at a mean of 4.2 mm from the posterior ridge and extends anteriorly an average of 7.4 mm. The pronator teres begins at a mean of 4.6 mm from the posterior ridge and extends an average of 5.7 mm anteriorly. The MCL starts at an average of 10.4 mm from the posterior ridge and extends 5.2 mm anteriorly., Conclusions: The measurements found have allowed the creation of a map of the specific common flexor tendon origins and their sizes on the medial epicondyle, as well as their position relative to the MCL., Clinical Relevance: A surgeon may debride 1 cm anteriorly from the posterior ridge of the medial epicondyle to safely address the affected tissues and ensure the safety and integrity of the MCL., Competing Interests: Conflicts of Interest No benefits in any form have been received or will be received related directly to this article., (Copyright © 2024 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)

Introduction and Importance: Several authors have also made reference to a less prevalent condition known in elbow as ulnar nerve subluxation. However, this particular condition tends to manifest primarily in young individuals who engage in professional sports or activities involving extensive use of the forearm. A more severe form of ulnar nerve subluxation, which is ulnar nerve dislocation, gives rise to a characteristic dislocation and relocation of the nerve at the elbow during flexion and extension of the forearm. Due to the rarity of this condition in clinical settings and its predominant occurrence as subluxation in younger patients, there are instances where traumatic ulnar nerve dislocation can be overlooked and misdiagnosed with two commonly encountered pathological conditions as ulnar nerve entrapment or medial epicondylitis., Case Presentation: The authors present a 51-year-old male with chronic pain when moving his right forearm following a fall that caused a direct force injury to his elbow. The patient was misdiagnosed and treated as medial epicondylitis and early-stage ulnar nerve entrapment. However, the symptoms did not improve for a long time. The authors performed the ulnar nerve anterior transposition surgery using the subcutaneous transposition technique and the result is very good without any pain., Clinical Discussion: The ulnar nerve can naturally be subluxed or dislocated if Osborne's ligament is loose or when there are anatomical variations in the medial epicondyle. In some case, this ligament can be ruptured by trauma. The symptoms of ulnar instability are caused by friction neuritis. Dynamic ultrasound of the ulnar nerve in two positions show clearly this condition., Conclusion: Post-traumatic ulnar nerve dislocation is a rare condition, and the recurrent characteristic of it leads to neuritis or neuropathy. The condition can be overlooked or misdiagnosed as medial epicondylitis or early-stage ulnar nerve entrapment. The nerve transposition surgery will give good result., Competing Interests: We declare that we have no known competing financial interests or personal relationships with anyone that could have appeared to influence the work reported in this paper.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Medial epicondylitis (ME), called "golfer's elbow", is not frequent or serious disease but can cause symptoms that are bothersome in everyday life. Therefore knowledge about this condition may improve diagnostic-therapeutic process. In this article detailed information concerning pathophysiology and symptomatology of ME was described. Great attention was paid to issues related to the diagnosis of the disease both in terms of differentiation with other elbow disorders as well as examination techniques. Finally, current therapeutic options were presented in detail and their efficacy was discussed based on the available data., Competing Interests: None

Introduction Video-sharing websites, especially YouTube search engine, have become popular sources for obtaining health information over the years. The reliability and quality of contents on YouTube are unpredictable and questionable. The purpose of this study was to evaluate the reliability and quality of videos on medial epicondylitis shared on the YouTube platform. Methods A YouTube search with the keywords "medial epicondylitis" and "golfer's elbow" was conducted. After typing each keyword, the first 50 videos that appeared in the first three pages were evaluated. The titles and duration of the videos, the uploading sources, the time passed since the upload, number of total views, likes, dislikes and comments were recorded. All videos were analyzed and scored using the DISCERN scoring system, modified DISCERN (mod-DISCERN) scale, and the Global Quality Score (GQS). Results Eighty-eight videos met the inclusion criteria and were included in the study. The mean DISCERN score, mod-DISCERN score and GQS were 40.68±10.5, 1.81±0.76, and 2.72±0.9, respectively. Most of the videos had poor and very poor quality content according to the DISCERN instrument, the mod-DISCERN scale and GQS tool. The main upload sources were doctors (36.4%), physiotherapists (25%), patients (2.2%), and other (36.4%). The videos uploaded by doctors had higher quality scores than other uploading sources. Of the 88 videos, 10 were about diagnosis alone, 39 were on treatment alone, and 39 contained information about both of diagnosis and treatment. The mean DISCERN score, mod-DISCERN score and GQS of the videos on "both" were significantly higher than those "diagnosis alone" and "treatment alone" groups. Conclusion Nearly 80% of YouTube videos on medial epicondylitis according to the DISCERN and GQS tool, and also 97.7% of videos according to the mod-DISCERN scale had medium or poor quality. YouTube videos on medial epicondylitis could not be considered as accurate and reliable sources. Because the videos uploaded by doctors had higher quality scores, the physicians should prepare and upload more reliable and quality contents with detailed information on YouTube., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Uzun et al.)

Background: Sesamoids and accessory bones are generally small-sized and oval-shaped structures whose function and pathology are not fully elucidated. Despite their small size, sesamoid bones can directly or indirectly cause diagnostic problems. Sesamoid bones are less common in the elbow region and may need to be differentiated from a lot of diagnoses such as fractures, osteochondritis dissecans, calcific tendinitis, and synovial chondromatosis., Case Presentation: A 55-year-old female patient presented with right elbow pain. An oval mass was seen near the medial epicondyle on the radiograph. A dynamic ultrasound examination was performed to reveal the relationship between the bone mass and the surrounding tissues, especially the ulnar nerve. Due to the well-circumscribed mass, a diagnosis of os subepicodlare mediale, a rare sesamoid bone, was made in light of current literature., Conclusions: When a bone mass is seen in patients presenting with elbow pain, it will be useful to know and consider the sesamoid bones. In addition, ultrasonography should be performed in addition to radiography for a localized sesamoid bone in the medial region and adjacent to the ulnar nerve. Thus, the relationship of the sesamoid bone with existing and potential complaints can be revealed and correct diagnosis-treatment approaches can be applied., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

To synthesize the available information on the effectiveness of platelet-rich plasma (PRP) injections against surgery as therapy strategies for medial epicondylitis (ME). We searched the Embase, MEDLINE, and Cochrane Library databases with the relevant keywords to identify the studies comparing the efficiency of PRP injections and ME surgery. We excluded non-English articles, case reports, and conference abstracts. Only two studies met the inclusion criteria and were included in the qualitative synthesis. No conflicts were reported between both studies. Both studies were carried out in the United States of America. The outcomes of PRP and surgical interventions were similar, with no reported statistical differences. Both studies recorded an excellent outcome following the PRP and surgical interventions, where the patients returned to full movement with no pain. The current evidence shows that PRP injections are just as effective as ME surgery in relieving pain and restoring function for those with ME, especially in the short and mid-term. Therefore, the injection of PRP is a promising treatment option for ME., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Alzahrani et al.)