Summary

Lateral collateral ligament tear often co-exist in patients with chronic tennis elbow without steroid injection and may suggest micro-instability in the pathogenesis of tennis elbow in this subgroup of patients.

Abstract

MRI scan of 53 patients with complaint of lateral epicondylitis for more than 1-year were reviewed. The average age is 50 years old (range 36-67) and male to female ratio is 3:2. Of these, lateral epicondylitis was all confirmed with MRI changes of common extensor origin oedema or tear. All patients with history of elbow dislocation, significant trauma or fracture to the elbow were excluded. Of these 19 (36%) patients had evidence of concomitant lateral collateral ligament complex sprain or partial tear. 9 (17%) patients had never had prior steroid injection. Age, gender, presence of inflammatory disease, occupation and shape of radial head (elliptical/circular) and neck shaft angle had no correlation to the presence of the collateral ligament tear. There was no macroscopic radiological evidence of radial head subluxation in the group with tear. Collateral ligament changes were often presence in patients with high grade partial tear. We conclude that collateral ligament tear often co-exists with common extensor tendinopathy, even in the absence of steroid injection. Collateral ligament tear and micro-instability may be associated with the pathogenesis of tennis elbow.