Which physical findings are characteristic of lateral epicondylitis (tennis elbow)?

Updated: Oct 30, 2018
  • Author: Bryant James Walrod, MD; Chief Editor: Craig C Young, MD  more...
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See the list below:

  • Inspection: Very rarely does one notice swelling or ecchymosis.

  • Palpation: Maximal tenderness is elicited 1-2 cm distal to the origin of the ECRB at the lateral epicondyle.

  • Pain is increased with resisted wrist extension, with the wrist radially deviated and pronated and the elbow extended

  • Pain may also increase when the patient attempts to lift the back of a chair with the elbow extended and the wrist maximally pronated.

  • Resisted extension of the middle finger is also painful secondary to stress placed on the ECRB tendon, as it is preferentially stressed in this position when it must contract synergistically to anchor the third metacarpal, such that extension can take place at the digits. [9]

  • Increased pain is noted with resisted supination, gripping hand shaking.

  • Always examine ROM of the shoulder, elbow, and wrist on the affected side.

  • Examine ROM and test for crepitus at the radiohumeral joint of the affected limb to evaluate for radiohumeral bursitis, osteochondritis of the capitellum, or PIN entrapment.

  • If decreased ROM if noted on physical examination, consider obtaining an x-ray to further evaluate the joint.

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