Tennis elbow or radial tunnel syndrome?

How can you determine if someone has elbow pain due to lateral epicondylitis (tennis elbow) or radial tunnel syndrome? Individuals with either injury may experience lateral elbow pain and weakness in power grip strength. This overlap in symptoms creates the potential for diagnostic confusion between the two conditions, as they share certain clinical features. However, several distinct clinical exam features may help to distinguish the two conditions:

With lateral epicondylitis:

  • The bony epicondyle of the humerus is tender to palpation
  • Resisted wrist extension yields weakness and the person’s familiar pain and
  • Use of a tendon counterforce strap or brace typically reduces pain.

With radial tunnel syndrome:

  • Tenderness to palpation is usually more distal, such as 5 cm down from the epicondyle
  • Resisted wrist extension strength is normal, while resisted extension of the 3rd finger may be weak or painful and
  • Use of a tendon strap typically increases the pain.

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