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Epicondilite

  • Обзор
  • Теория
  • Диагноз
  • Лечение
  • Последующее наблюдение
  • Источники
Последний просмотренный: 15 Jul 2025
Last updated: 11 Mar 2025

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • presença de fatores de risco
  • dor no cotovelo durante ou após a flexão e extensão
  • exacerbação da dor com movimento ou atividade ocupacional repetitivos
  • redução da força de preensão
  • dor na região lateral do cotovelo (epicondilite lateral)
  • dor à palpação sobre o tendão extensor comum (epicondilite lateral)
  • estiramento positivo do extensor radial curto do carpo (epicondilite lateral)
  • dor durante a extensão do punho e dedos contra resistência (epicondilite lateral)
  • dor na região medial do cotovelo (epicondilite medial)
  • dor à palpação aproximadamente 5 mm distal e lateral ao epicôndilo medial (epicondilite medial)
  • dor elevada com flexão do punho ou pronação do antebraço contra resistência (epicondilite medial)
Полная информация

Другие диагностические факторы

  • amplitude de movimentos normal no cotovelo
  • sensibilidade normal
  • sinal de Tinel negativo
  • extensão fraca do punho (epicondilite lateral)
  • edema
Полная информация

Факторы риска

  • aumento da idade (>40 anos)
  • história médica de epicondilite
  • atividades repetitivas
  • mecânica incorreta durante as atividades
  • equipamentos inadequados
  • condicionamento físico inadequado
  • tabagismo
  • obesidade
  • sintomas ocorrendo no mesmo lado que a mão dominante
  • sexo feminino
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • nenhum exame inicial (diagnóstico clínico)
Полная информация

Исследования, проведение которых нужно рассмотреть

  • radiografia do cotovelo
  • tomografia computadorizada (TC) do cotovelo
  • RNM do cotovelo
  • ressonância nuclear magnética (RNM) da coluna cervical
  • estudos de eletromiografia e condução nervosa
  • ultrassonografia do cotovelo
Полная информация

Алгоритм лечения

Острый

apresentação inicial

ПРОДОЛЖЕНИЕ

nenhuma resposta ao tratamento inicial em 6 semanas

epicondilite lateral refratária ao tratamento 6 a 12 meses após a apresentação inicial

epicondilite medial refratária ao tratamento 6 a 12 meses após a apresentação inicial

Составители

Авторы

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

Consultant Hand and Upper Limb Surgeon

Wrightington Hospital

Appley Bridge

Wigan

UK

Раскрытие информации

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

Раскрытие информации

PMR declares that he has no competing interests.

Выражение благодарностей

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.

Рецензенты

Frank G. Alberta, MD, FAAOS

Associate Professor of Orthopaedic Surgery

Hackensack Meridian School of Medicine

Nutley

NJ

Раскрытие информации

FGA declares that he has no competing interests.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

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

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. Аннотация

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

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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