Evaluation of Lateral Epicondylitis using MRI: A Clinical Study

Introduction: Lateral epicondylitis results from repetitive strain on the extensor and supinator muscles of the wrist and forearm. Magnetic resonance imaging (MRI), known for its superior soft tissue contrast resolution, has shown satisfactory sensitivity, specificity, and accuracy in diagnosing lateral epicondylitis. The purpose of this research was to assess the effectiveness of MRI in patients diagnosed with lateral epicondylitis. Materials and Methods: A randomized investigation was performed on a cohort of 123 consecutive patients, including 82 males and 41 females, all clinically diagnosed with chronic lateral epicondylitis. Each patient underwent a 3.0 T MRI scan, and the extent of tendinopathy was evaluated using a dedicated MRI scoring system. Clinical symptoms were measured using the Patient Rated Tennis Elbow Evaluation (PRTEE). The statistical analysis was carried out using SPSS version 21 software. Results: MRI identified tendinopathy in all 123 elbows: 52 (42.3%) were grade 1, 38 (30.9%) grade 2, and 33 (26.8%) grade 3. Intra-observer agreement averaged 80.2%, with weighted kappa values of 0.79, 0.74, and 0.89 (P < 0.001) for individual radiologists, reflecting good reliability. Inter-observer reliability had a weighted kappa of 0.72. The median PRTEE score was 77 (range 8-96), with scores of 19, 23, and 60 for grades 1, 2, and 3, respectively. PRTEE scores increased with tendinopathy severity, showing a significant positive correlation (Spearman’s r = 0.94, P < 0.01). Conclusion: MRI serves as a reliable imaging modality for evaluating the radiological severity of chronic lateral epicondylitis, with the severity of MRI-detected signal changes correlating positively with the patient’s clinical symptoms.