Evaluation and Surveillance of Lateral Elbow Tendinopathy in Manual Workers: Identifying Elbows at Risk

Background: Manual workers are at risk of developing lateral elbow tendinopathy (LET). We aimed to validate the hypothesis that asymptomatic elbows of manual workers with LET are more likely to have positive physical examination results and morpho-mechanical changes on elbow ultrasonography compared...

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Main Authors: Chih-Chien Hung, Hsin-Shui Chen, Chih-Hao Chang, Ming-Wei Wang, Kun-Lin Hung, Hsing-Kuo Wang
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Journal of Medical Ultrasound
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Online Access:https://journals.lww.com/10.4103/jmu.jmu_22_24
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author Chih-Chien Hung
Hsin-Shui Chen
Chih-Hao Chang
Ming-Wei Wang
Kun-Lin Hung
Hsing-Kuo Wang
author_facet Chih-Chien Hung
Hsin-Shui Chen
Chih-Hao Chang
Ming-Wei Wang
Kun-Lin Hung
Hsing-Kuo Wang
author_sort Chih-Chien Hung
collection DOAJ
description Background: Manual workers are at risk of developing lateral elbow tendinopathy (LET). We aimed to validate the hypothesis that asymptomatic elbows of manual workers with LET are more likely to have positive physical examination results and morpho-mechanical changes on elbow ultrasonography compared to healthy individuals. Methods: This cross-sectional case–control study included 30 manual workers with unilateral LET (LET group) and 30 age- and sex-matched healthy volunteers (control group). Demographic data collection and functional evaluation were performed using the Disabilities of the Arm, Shoulder, and Hand; Patient-Rated Tennis Elbow Evaluation; and European Quality of Life Five-Dimensions questionnaires. Physical examination of the elbows and evaluation of the common extensor tendon (CET) with B-mode morphology ultrasonography and Young’s modulus elastography were performed. The LET-unaffected and LET-affected elbows in the LET group were compared with the elbows in the control group. Results: The LET-unaffected elbows in the LET group had a higher prevalence of positive chair test results and focal hypoechoic change and microcalcification on ultrasonography than those in the control group (P < 0.05, 0.005, and 0.05, respectively). In addition, LET-affected elbows showed higher focal hypoechoic change, microcalcification, erosive cortex, and neovascularity than elbows in the control group (P < 0.001, 0.001, 0.005, and 0.001, respectively). The unaffected and affected elbows showed greater CET thickness than those in the control group (P < 0.05 and 0.005). Conclusion: The unaffected elbows of manual workers with unilateral LET should be considered at risk of LET. We proposed a risk assessment and surveillance protocol based on chair test results and abnormal ultrasonographic findings.
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spelling doaj-art-58143992ea3d4745ae43b74eaeda522d2025-08-20T03:03:34ZengWolters Kluwer Medknow PublicationsJournal of Medical Ultrasound0929-64412212-15522025-01-01331475310.4103/jmu.jmu_22_24Evaluation and Surveillance of Lateral Elbow Tendinopathy in Manual Workers: Identifying Elbows at RiskChih-Chien HungHsin-Shui ChenChih-Hao ChangMing-Wei WangKun-Lin HungHsing-Kuo WangBackground: Manual workers are at risk of developing lateral elbow tendinopathy (LET). We aimed to validate the hypothesis that asymptomatic elbows of manual workers with LET are more likely to have positive physical examination results and morpho-mechanical changes on elbow ultrasonography compared to healthy individuals. Methods: This cross-sectional case–control study included 30 manual workers with unilateral LET (LET group) and 30 age- and sex-matched healthy volunteers (control group). Demographic data collection and functional evaluation were performed using the Disabilities of the Arm, Shoulder, and Hand; Patient-Rated Tennis Elbow Evaluation; and European Quality of Life Five-Dimensions questionnaires. Physical examination of the elbows and evaluation of the common extensor tendon (CET) with B-mode morphology ultrasonography and Young’s modulus elastography were performed. The LET-unaffected and LET-affected elbows in the LET group were compared with the elbows in the control group. Results: The LET-unaffected elbows in the LET group had a higher prevalence of positive chair test results and focal hypoechoic change and microcalcification on ultrasonography than those in the control group (P < 0.05, 0.005, and 0.05, respectively). In addition, LET-affected elbows showed higher focal hypoechoic change, microcalcification, erosive cortex, and neovascularity than elbows in the control group (P < 0.001, 0.001, 0.005, and 0.001, respectively). The unaffected and affected elbows showed greater CET thickness than those in the control group (P < 0.05 and 0.005). Conclusion: The unaffected elbows of manual workers with unilateral LET should be considered at risk of LET. We proposed a risk assessment and surveillance protocol based on chair test results and abnormal ultrasonographic findings.https://journals.lww.com/10.4103/jmu.jmu_22_24elbow tendinopathyoccupational healthrisk assessmenttennis elbowultrasonography
spellingShingle Chih-Chien Hung
Hsin-Shui Chen
Chih-Hao Chang
Ming-Wei Wang
Kun-Lin Hung
Hsing-Kuo Wang
Evaluation and Surveillance of Lateral Elbow Tendinopathy in Manual Workers: Identifying Elbows at Risk
Journal of Medical Ultrasound
elbow tendinopathy
occupational health
risk assessment
tennis elbow
ultrasonography
title Evaluation and Surveillance of Lateral Elbow Tendinopathy in Manual Workers: Identifying Elbows at Risk
title_full Evaluation and Surveillance of Lateral Elbow Tendinopathy in Manual Workers: Identifying Elbows at Risk
title_fullStr Evaluation and Surveillance of Lateral Elbow Tendinopathy in Manual Workers: Identifying Elbows at Risk
title_full_unstemmed Evaluation and Surveillance of Lateral Elbow Tendinopathy in Manual Workers: Identifying Elbows at Risk
title_short Evaluation and Surveillance of Lateral Elbow Tendinopathy in Manual Workers: Identifying Elbows at Risk
title_sort evaluation and surveillance of lateral elbow tendinopathy in manual workers identifying elbows at risk
topic elbow tendinopathy
occupational health
risk assessment
tennis elbow
ultrasonography
url https://journals.lww.com/10.4103/jmu.jmu_22_24
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