Elbow

The elbow joint is a complex synovial joint allowing flexion, extension, and forearm rotation with movements facilitated by ligamentous insertions. Although less common than pain at some other regional sites, epidemiological surveys suggest that elbow pain affects around 12% of adults at any point in time and occurs at equal rates among men and women. The differential diagnosis of elbow pain must always consider the possibility of: a multisystem inflammatory arthropathy such as rheumatoid arthritis or gout; a chronic widespread pain condition such as fibromyalgia syndrome; referred pain; or a more unusual disease such as bone metastasis from a distant primary. However, the most common causes of elbow symptoms are soft tissue periarticular conditions such as lateral and medial epicondylitis and olecranon bursitis and ulnar neuropathy. Although widely diagnosed and widely treated, there remain few convincing data from high-quality randomized controlled trials as to the long-term safety and efficacy of most ’standard’ treatments for these soft tissue conditions.