EPICONDYLITIS

1. So-called "epicondylitis," a condition characterized by pain originating in and about the lateral humeral condyle, radiating down the forearm and hand, and giving rise to disability of greater or less extent, constitutes a definite clinical entity, which it is important to recognize.

2. It occurs almost exclusively in adults between the ages of thirty and fifty, in women more frequently than men, and seems to follow certain occupational or sport activities, particularly those in which the combined movements of supination and flexion of the forearm are employed.

3. The characteristic feature of the condition is pain, as described above, associated usually with a complete lack of objective findings.

4. No definite pathology is known which will apply to all cases. It is probable that the majority of cases are due to a localized periostitis in the region of the external epicondyle, the result of opposing muscle action frequently repeated. A smaller number of cases are undoubtedly due to inflammation or calcification in a bursa which is sometimes found in this region.

5. The ultimate prognosis is good, as all cases eventually recover, but the course of the disease is characterized by extreme chronicity.

6. The great majority of cases in which there is a complete absence of objective findings, are best treated by prolonged rest; diathermy may be of value; a small number, especially those in which the presence of an inflamed bursa is suspected or proved, should be treated surgically.

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