HSS Ultrasound of the Month Case 150

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Clinical History

65 year old male with chronic lateral elbow pain.

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Diagnosis: Lateral Epicondylitis with Partial Thickness Extensor Tendon Tear

Lateral epicondylitis encompasses a spectrum of tendinopathy of the common extensor tendon with or without a superimposed tendon tear.

There are several treatment options available for lateral epicondylitis, including ultrasound-guided procedures.

Under ultrasound guidance, treatment options include tenotomy with or without platelet-rich plasma (PRP) injection, and cortisone injection.

Tenotomy involves needling the abnormal tendon including the site of the tear, and PRP injection, if performed, is done directly into the tendon.

Cortisone, in contrast, is injected around the tendon rather than into the tendon.

Ultrasound-guidance, compared to palpation-guided techniques, allows precise placement of the needle into the abnormal area of the tendon during tenotomy and injections.

Other injections that have been described include autologous blood, botox, and hypertonic dextrose.

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