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The Predictive Value of Diagnostic Sonography for the Effectiveness of Conservative Treatment of Tennis Elbow

P. A. A. Struijs1, M. Spruyt2, W. J. J. Assendelft3 and C. N. van Dijk1

1 Department of Orthopaedic Surgery, Academic Medical Center, Meibergdreef 9, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
2 School for Medical Imaging and Radiodiagnostic Studies, Haarlem, The Netherlands.
3 Division of Public Health, Department of General Practice, Academic Medical Center, Amsterdam, The Netherlands.



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  		Fig. 1A —Normal common extensor tendon in 44-year-old woman. Sonogram shows common extensor tendon without abnormality.

 


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  		Fig. 1B —Normal common extensor tendon in 44-year-old woman. Drawing shows normal common extensor tendon. 1 = lateral humeral epicondyle, 2 = radial head, 3 = annular ligament, 4 = supinator muscle, 5 = origin of common extensor tendon.

 


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  		Fig. 2A —Abnormal insertion of common extensor tendon in 38-year-old woman. Sonogram of shows elbow with abnormal insertion of common extensor tendon.

 


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  		Fig. 2B —Abnormal insertion of common extensor tendon in 38-year-old woman. Drawing shows abnormal insertion of common extensor tendon. 1 = lateral humeral epicondyle, 2 = radial head, 3 = annular ligament, 4 = supinator muscle, 5 = tendon insertion with swelling and hypoechogenicity at origin of common extensor tendon (enthesopathy).

 


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  		Fig. 3 —Bar graph shows success rates for all patients (bars with diagonal lines), brace-only group (black bars), physical therapy-only group (gray bars), and combination therapy group (white bars) by sonographic finding subgroups.

 

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