ABSTRACT
Clinical problems 1. Tennis elbow (lateral epicondylitis). This is commonest in the fourth and fifth decades and may be related to degenerative change in the connective tissues. It is also seen in amateur tennis players, where it is related to their backhand stroke, and in professionals in relation to their serve. The pain is of gradual origin and is usually well localized, but it may radiate to the extensor aspect of the forearm. Patients often complain of a weak grip and of dropping objects. Resisted wrist extension is painful. Tenderness is usually localized to the lateral epicondyle and supracondylar ridge. The pathology is uncertain but is probably that of a degenerative or traumatic tear of the tendo-periosteal attachment of extensor carpi radialis brevis and the common extensor muscle origin. Other theories include a humero-radial bursitis, inflammation of the annular ligament of the radius, the presence of a synovial fold between the humerus and radial head and posterior interosseous nerve entrapment.
