When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Epicondylitis

Última revisão: 17 Aug 2025
Última atualização: 11 Mar 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • history of repetitive recreational or occupational activity
  • past medical history of epicondylitis
  • smoking
  • elbow pain during or following flexion and extension
  • exacerbation of pain with repetitive movement or occupational activity
  • decreased grip strength
  • pain at the lateral aspect of the elbow (lateral epicondylitis)
  • tenderness over the common extensor tendon (lateral epicondylitis)
  • positive extensor carpi radialis brevis stretch (lateral epicondylitis)
  • pain during resisted wrist and digit extension (lateral epicondylitis)
  • pain at the medial aspect of the elbow (medial epicondylitis)
  • tenderness approximately 5 mm distal and lateral to the medial epicondyle (medial epicondylitis)
  • increased pain with resisted forearm pronation or wrist flexion (medial epicondylitis)
Detalhes completos

Outros fatores diagnósticos

  • normal range of movement at elbow
  • normal sensation
  • Tinel sign negative
  • weak wrist extension (lateral epicondylitis)
  • swelling
Detalhes completos

Fatores de risco

  • increasing age (>40 years)
  • past medical history of epicondylitis
  • repetitive activities
  • poor mechanics during activities
  • improper equipment
  • inadequate physical conditioning
  • smoking
  • obesity
  • symptoms occurring on the same side as hand dominance
  • female sex
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • no initial tests (clinical diagnosis)
Detalhes completos

Investigações a serem consideradas

  • elbow x-ray
  • computed tomographic scan of the elbow
  • MRI of the elbow
  • MRI of the cervical spine
  • electromyogram and nerve conduction studies
  • ultrasound of the elbow
Detalhes completos

Algoritmo de tratamento

AGUDA

initial presentation

CONTÍNUA

no response to initial treatment at 6 weeks

lateral epicondylitis refractory to treatment 6-12 months after initial presentation

medial epicondylitis refractory to treatment 6-12 months after initial presentation

Colaboradores

Autores

Adam C. Watts, BSc, MBBS, FRCS (Tr and Ortho)

Consultant Hand and Upper Limb Surgeon

Wrightington Hospital

Appley Bridge

Wigan

UK

Declarações

ACW has received payment for education from Medartis and Wright Medical. His institution has received funding for research from Chemedica, ZimmerBiomet, Wright Medical, Stryker and Lima.

Paul M. Robinson, FRCS (Tr&Orth), BMedSci, MBChB (Hons)

Consultant Trauma and Orthopaedic Surgeon

Peterborough City Hospital

North West Anglia NHS Foundation Trust

Peterborough

UK

Declarações

PMR declares that he has no competing interests.

Agradecimentos

Dr Adam C. Watts and Dr Paul M. Robinson would like to gratefully acknowledge Dr Len Funk, Dr Iain Macleod, Dr Daniel J. Soloman, and Dr Hugo B. Sanchez, previous contributors to this topic. LF, IM, DJS, and HBS declare that they have no competing interests.

Revisores

Frank G. Alberta, MD, FAAOS

Associate Professor of Orthopaedic Surgery

Hackensack Meridian School of Medicine

Nutley

NJ

Declarações

FGA declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

American College of Radiology. Practice parameter for the performance and interpretation of magnetic resonance imaging (MRI) of the elbow. 2021 [internet publication].Texto completo

American College of Radiology. ACR appropriateness criteria: acute elbow and forearm pain​. 2024 [internet publication].Texto completo

Raman J, MacDermid JC, Grewal R. Effectiveness of different methods of resistance exercises in lateral epicondylosis - a systematic review. J Hand Ther. 2012 Jan-Mar;25(1):5-25. Resumo

National Institute for Health and Care Excellence. Autologous blood injection for tendinopathy. Jan 2013 [internet publication].Texto completo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Epicondylitis images
  • Diagnósticos diferenciais

    • Radial tunnel syndrome
    • Radiocapitellar plica
    • Osteoarthritis
    Mais Diagnósticos diferenciais
  • Diretrizes

    • ACR Appropriateness Criteria: acute elbow and forearm pain
    • Lateral epicondyle tendinopathy (LET) toolkit
    Mais Diretrizes
  • Folhetos informativos para os pacientes

    Tennis elbow

    Mais Folhetos informativos para os pacientes
  • padlock-lockedConectar-se ou assinar para acessar todo o BMJ Best Practice

O uso deste conteúdo está sujeito ao nosso aviso legal