Purpose: Evaluation of the diagnostic value and confidence of contrast-enhanced MR imaging in patients with lateral epicondylitis in comparison to clinical diagnosis.
Material and methods: 42 consecutive patients with clinically proven chronic lateral epicondylitis and 10 elbow joints of healthy controls have been examined on a 1.0 T MR-unit. Criteria for inclusion in the prospective study were: persistent pain and a failed conservative therapy. The MR protocol included STIR sequence, a native, T2-weighted, fat-suppressed TSE sequence, and a Flash-2-D sequence. Also, fat-suppressed, T1-weighted SE sequences before and after administration of Gd-DTPA contrast media have been recorded.
Results: In 39/42 patients the STIR sequence showed an increased SI of the common extensor tendon. Increased MR signal of the lateral collateral ligament combined with a thickening and a partial rupture or a full thickness tear have been observed in 15/42 cases. A bone marrow edema at the lateral epicondilus was noticed in 6 of the studied patients and a joint effusion in 18/42 patients. After administration of contrast media we noticed an average increase of SI by about 150%. However, enhanced MR imaging did not provide additional information.
Conclusion: In MR imaging of chronic epicondylitis administration of gadolinium-DTPA does not provide additional information.