How is it Diagnosed?
Tennis elbow, or lateral epicondylitis, is diagnosed primarily through a detailed clinical
history and physical examination. Patients typically report pain and tenderness over the
lateral epicondyle of the elbow, which worsens with gripping or lifting activities. The
dominant arm is usually affected, and the condition is often related to repetitive strain
from activities like racquet sports, carpentry, or typing.
During physical examination, specific tests are conducted to elicit pain and confirm
diagnosis. The Cozen’s test (resisted wrist extension with the elbow extended) and the
Mill’s test (passive wrist flexion with the elbow extended) are commonly used. Both
tests reproduce the characteristic pain at the lateral elbow.
Imaging is not usually required for diagnosis but may be employed in chronic or severe
cases to rule out other conditions such as arthritis or radial tunnel syndrome. X-rays
may help exclude joint or bone abnormalities. Ultrasound can reveal changes in the
tendon structure, such as thickening or tears. MRI provides detailed imaging of soft
tissues and is useful when symptoms persist despite conservative treatment.
Electrodiagnostic studies like nerve conduction studies may be used to rule out radial
nerve entrapment if neurological symptoms are present. The diagnosis is clinical in most
cases, and imaging is reserved for atypical or refractory presentations. Early diagnosis
aids in conservative management, including rest, physiotherapy, and anti-inflammatory
measures.