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Yves Roquelaure - One of the best experts on this subject based on the ideXlab platform.
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Incidence of ulnar nerve entrapment at the elbow in repetitive work
Scandinavian Journal of Work Environment & Health, 2004Co-Authors: Alexis Descatha, Anisette Leclerc, Jean-françois Chastang, Yves RoquelaureAbstract:OBJECTIVES: Despite the high frequency of work-related musculoskeletal disorders, the relation between work conditions and ulnar nerve entrapment at the elbow has not been the object of much research. In the present study, the predictive factors for such ulnar nerve entrapment were determined in a 3-year prospective survey of upper-limb work-related musculoskeletal disorders in repetitive work. METHODS: In 1993-1994 and 3 years later, 598 workers whose jobs involved repetitive work underwent an examination by their occupational health physicians and completed a self-administered questionnaire. Predictive factors associated with the onset of ulnar nerve entrapment at the elbow were studied with bivariate and multivariate analyses. RESULTS: The annual incidence was estimated at 0.8% per person-year, on the basis of 15 new cases during the 3-year period. Holding a tool in position was the only predictive biomechanical factor [odds ratio (OR) 4.1, 95% confidence interval (95% CI) 1.4-12.0]. Obesity increased the risk of ulnar nerve entrapment at the elbow (OR 4.3, 95% CI 1.2-16.2), as did the presence of Medial Epicondylitis, carpal tunnel syndrome, radial tunnel syndrome, and cervicobrachial neuralgia. The associations with "holding a tool in position" and obesity were unchanged when the presence of other diagnoses was taken into account. CONCLUSIONS: Despite the limitations of the study, the results suggest that the incidence of ulnar nerve entrapment at the elbow is associated with one biomechanical risk factor (holding a tool in position, repetitively), overweight, and other upper-limb work-related musculoskeletal disorders, especially Medial Epicondylitis and other nerve entrapment disorders (cervicobrachial neuralgia and carpal and radial tunnel syndromes).
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Medial Epicondylitis in occupational settings prevalence incidence and associated risk factors
Journal of Occupational and Environmental Medicine, 2003Co-Authors: Alexis Descatha, Jean-françois Chastang, Annette Leclerc, Yves RoquelaureAbstract:Because Medial Epicondylitis has not been studied alone, we investigated its links between personal and occupational factors in repetitive work and its course. A total of 1757 workers were examined by an occupational health physician in 1993-1994. Five hundred ninety-eight of them were reexamined 3 years later. Prevalence was between 4% and 5%, with an annual incidence estimate at 1.5%. Forceful work was a risk factor (odds ratio [OR], 1.95; confidence interval [CI] = 1.15-3.32), but not exposure to repetitive work (OR, 1.11; CI = 0.59-2.10). Workers with Medial Epicondylitis had a significantly higher prevalence of other work-related upper-limb musculoskeletal disorders (WRMD). Risk factors differed for Medial and lateral Epicondylitis. The prognosis for Medial Epicondylitis in this population was good with a 3-year recovery rate at 81%. Medial Epicondylitis was clearly associated with forceful work and other upper-limb WRMD, and its prognosis was good.
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Les épicondylites médiales en milieu de travail : évolution et prévention.
Archives des Maladies Professionnelles et de Medecine du Travail, 2003Co-Authors: Alexis Descatha, Jean-françois Chastang, Annette Leclerc, Yves RoquelaureAbstract:Purpose of the study: We studied the evolution of Medial Epicondylitis, the association with other work related musculoskeletal disorders, and the consequences for prevention. Methods: In 1993-1994 and again in 1996-1997, 598 workers exposed to repetitive job were examined by 18 occupational health physicians and completed a self-administered questionnaire. The study was performed in order to consider all upper-limb occupational disorders; we focused here on the evolution and prevention of Medial Epicondylitis. Results: Prevalence was 5.2 percent in this population. Annual incidence was estimated at 1.5 percent. Medial Epicondylitis had a good medical (recovering rate 81 % CI [63%;92%]) and professional prognosis. There was a claim for occupational disease compensation for four percent of Medial Epicondylitis. Forceful job was associated with prevalence, but was not found as a risk factor for incidence. Other upper-limb occupational disorders, especially shoulder tendinitis, carpal tunnel syndrome, lateral Epicondylitis, and ulnar nerve syndrome at elbow were associated with incidence of Medial Epicondylitis (Relative Risk = 2.5 ;CI[1.01;6.00]), suggesting that this disorder is secondary to other work-related disorders. Conclusions: Medial Epicondylitis had a good prognosis in our study. The disorder could be detected easily by the occupational physicians, especially in the population at high risk. In our study, workers recovered without changing their working conditions
Alexis Descatha - One of the best experts on this subject based on the ideXlab platform.
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self reported physical exposure association with Medial and lateral Epicondylitis incidence in a large longitudinal study
Occupational and Environmental Medicine, 2013Co-Authors: Alexis Descatha, Ann Marie Dale, Lisa Jaegers, Eleonore Herquelot, Bradley A EvanoffAbstract:Introduction Although previous studies have related occupational exposure and Epicondylitis, the evidence is moderate and mostly based on cross-sectional studies. Suspected physical exposures were tested over a 3-year period in a large longitudinal cohort study of workers in the USA. Method In a population-based study including a variety of industries, 1107 newly employed workers were examined; only workers without elbow symptoms at baseline were included. Baseline questionnaires collected information on personal characteristics and self-reported physical work exposures and psychosocial measures for the current or most recent job at 6 months. Epicondylitis (lateral and Medial) was the main outcome, assessed at 36 months based on symptoms and physical examination (palpation or provocation test). Logistic models included the most relevant associated variables. Results Of 699 workers tested after 36 months who did not have elbow symptoms at baseline, 48 suffered from Medial or lateral Epicondylitis (6.9%), with 34 cases of lateral Epicondylitis (4.9%), 30 cases of Medial Epicondylitis (4.3%) and 16 workers who had both. After adjusting for age, lack of social support and obesity, consistent associations were observed between self-reported wrist bending/twisting and forearm twisting/rotating/screwing motion and future cases of Medial or lateral Epicondylitis (ORs 2.8 (1.2 to 6.2) and 3.6 (1.2 to 11.0) in men and women, respectively). Conclusions Self-reported physical exposures that implicate repetitive and extensive/prolonged wrist bend/twisting and forearm movements were associated with incident cases of lateral and Medial Epicondylitis in a large longitudinal study, although other studies are needed to better specify the exposures involved.
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Incidence of ulnar nerve entrapment at the elbow in repetitive work
Scandinavian Journal of Work Environment & Health, 2004Co-Authors: Alexis Descatha, Anisette Leclerc, Jean-françois Chastang, Yves RoquelaureAbstract:OBJECTIVES: Despite the high frequency of work-related musculoskeletal disorders, the relation between work conditions and ulnar nerve entrapment at the elbow has not been the object of much research. In the present study, the predictive factors for such ulnar nerve entrapment were determined in a 3-year prospective survey of upper-limb work-related musculoskeletal disorders in repetitive work. METHODS: In 1993-1994 and 3 years later, 598 workers whose jobs involved repetitive work underwent an examination by their occupational health physicians and completed a self-administered questionnaire. Predictive factors associated with the onset of ulnar nerve entrapment at the elbow were studied with bivariate and multivariate analyses. RESULTS: The annual incidence was estimated at 0.8% per person-year, on the basis of 15 new cases during the 3-year period. Holding a tool in position was the only predictive biomechanical factor [odds ratio (OR) 4.1, 95% confidence interval (95% CI) 1.4-12.0]. Obesity increased the risk of ulnar nerve entrapment at the elbow (OR 4.3, 95% CI 1.2-16.2), as did the presence of Medial Epicondylitis, carpal tunnel syndrome, radial tunnel syndrome, and cervicobrachial neuralgia. The associations with "holding a tool in position" and obesity were unchanged when the presence of other diagnoses was taken into account. CONCLUSIONS: Despite the limitations of the study, the results suggest that the incidence of ulnar nerve entrapment at the elbow is associated with one biomechanical risk factor (holding a tool in position, repetitively), overweight, and other upper-limb work-related musculoskeletal disorders, especially Medial Epicondylitis and other nerve entrapment disorders (cervicobrachial neuralgia and carpal and radial tunnel syndromes).
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Medial Epicondylitis in occupational settings prevalence incidence and associated risk factors
Journal of Occupational and Environmental Medicine, 2003Co-Authors: Alexis Descatha, Jean-françois Chastang, Annette Leclerc, Yves RoquelaureAbstract:Because Medial Epicondylitis has not been studied alone, we investigated its links between personal and occupational factors in repetitive work and its course. A total of 1757 workers were examined by an occupational health physician in 1993-1994. Five hundred ninety-eight of them were reexamined 3 years later. Prevalence was between 4% and 5%, with an annual incidence estimate at 1.5%. Forceful work was a risk factor (odds ratio [OR], 1.95; confidence interval [CI] = 1.15-3.32), but not exposure to repetitive work (OR, 1.11; CI = 0.59-2.10). Workers with Medial Epicondylitis had a significantly higher prevalence of other work-related upper-limb musculoskeletal disorders (WRMD). Risk factors differed for Medial and lateral Epicondylitis. The prognosis for Medial Epicondylitis in this population was good with a 3-year recovery rate at 81%. Medial Epicondylitis was clearly associated with forceful work and other upper-limb WRMD, and its prognosis was good.
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Les épicondylites médiales en milieu de travail : évolution et prévention.
Archives des Maladies Professionnelles et de Medecine du Travail, 2003Co-Authors: Alexis Descatha, Jean-françois Chastang, Annette Leclerc, Yves RoquelaureAbstract:Purpose of the study: We studied the evolution of Medial Epicondylitis, the association with other work related musculoskeletal disorders, and the consequences for prevention. Methods: In 1993-1994 and again in 1996-1997, 598 workers exposed to repetitive job were examined by 18 occupational health physicians and completed a self-administered questionnaire. The study was performed in order to consider all upper-limb occupational disorders; we focused here on the evolution and prevention of Medial Epicondylitis. Results: Prevalence was 5.2 percent in this population. Annual incidence was estimated at 1.5 percent. Medial Epicondylitis had a good medical (recovering rate 81 % CI [63%;92%]) and professional prognosis. There was a claim for occupational disease compensation for four percent of Medial Epicondylitis. Forceful job was associated with prevalence, but was not found as a risk factor for incidence. Other upper-limb occupational disorders, especially shoulder tendinitis, carpal tunnel syndrome, lateral Epicondylitis, and ulnar nerve syndrome at elbow were associated with incidence of Medial Epicondylitis (Relative Risk = 2.5 ;CI[1.01;6.00]), suggesting that this disorder is secondary to other work-related disorders. Conclusions: Medial Epicondylitis had a good prognosis in our study. The disorder could be detected easily by the occupational physicians, especially in the population at high risk. In our study, workers recovered without changing their working conditions
R. Dadej - One of the best experts on this subject based on the ideXlab platform.
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Extacorporeal shock wave therapy unsuccessful for chronic Medial Epicondylitis
Journal of Orthopaedics and Traumatology, 2007Co-Authors: P. Grala, R. DadejAbstract:Medial Epicondylitis is a chronic noninflammatory condition resulting from mechanical injury. Despite many treatment options, including rest, medications, physiotherapy and operative interventions, the results are too often poor; thus new treatment options are sought. We treated 4 men with chronic Epicondylitis (5 affected joints) with extracorporeal shock wave therapy after failed attempts of other treatments. The patients’ complaints were graded with the Nirschl scoring system prior to and six months after therapy. The treatment consisted of three sessions, at 20-day intervals, of 3000 pulses of ultrasonic shock waves from a Piezolith 3000 unit (energy dosage was gradually increased to reach step 10 equaling 0.9 mJ/mm^2). At the 6-month follow-up, no patient was pain free. Three cases had slightly lower Nirschl scores than prior to the procedure but the patients rated this difference as insignificant; two cases were unchanged. No complications were observed but all patients rated the procedure as very unpleasant. The well recognized biologic effects of ultrasonographic waves (heat generation, oscillations, cavitation, etc.) that result in functional and structural changes of cellular membranes with sonochemical reactions (acceleration of normal metabolism, oxygenation and reduction in water solutions, polymer degradation, etc.), even if present in our cases, did not result in a noticeable decrease of symptoms, even though we used high energy and more impulses per session. Significant variations in methodology make inconclusive the results of numerous reports on the use of extracorporeal shock waves in epicondylar degenerative problems, although ineffectiveness of such therapy is the conclusion of a review by Haake and colleagues.
Jinyoung Bang - One of the best experts on this subject based on the ideXlab platform.
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clinical applicability of shear wave elastography for the evaluation of Medial Epicondylitis
European Radiology, 2021Co-Authors: Jinyoung Bang, Seok Hahn, Yunjung Lim, Hyun Kyung JungAbstract:To evaluate the ability of shear wave elastography (SWE) in diagnosing Medial Epicondylitis and to compare the diagnostic performance of SWE with that of grey-scale ultrasound (GSU) and strain elastography (SE). GSU, SE, and SWE were performed on 61 elbows of 54 patients from March 2018 to April 2019. An experienced radiologist evaluated the GSU findings (swelling, cortical irregularity, hypoechogenicity, calcification, and tear), colour Doppler findings (hyperaemia), SE findings (strain ratio [SR]), and SWE findings (stiffness and shear wave velocity [SWV]). Participants were divided in two groups: patients with clinically diagnosed Medial Epicondylitis and patients without Medial elbow pain. Findings from the two groups were compared, and the receiver operating characteristic (ROC) curves were calculated for significant features. Of the 54 patients, 25 patients with 28 imaged elbows were clinically diagnosed with Medial Epicondylitis and 29 patients with 33 imaged elbows had no Medial elbow pain. Cortical irregularity, hypoechogenicity, calcification, hyperaemia, SR, stiffness, and SWV were significantly different between the two groups. The areas under the ROC curves were 0.838 for hypoechogenicity, 0.948 for SR, 0.999 for stiffness, and 0.999 for SWV. The diagnostic performances of SR, stiffness, and SWV were significantly superior compared to that of hypoechogenicity. However, there were no significant differences among SR, stiffness, and SWV. SWE can obtain both stiffness and SWV, which are valuable diagnostic tools in the diagnosis of Medial Epicondylitis. The diagnostic performance of SWE and SE is similar in detecting Medial Epicondylitis. • Shear wave elastography providing stiffness and shear wave velocity showed excellent performance in the diagnosis of Medial Epicondylitis. • There was no significant difference in the ability of SE and SWE for diagnosing Medial Epicondylitis.
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clinical application of real time sonoelastography for evaluation of Medial Epicondylitis a pilot study
Ultrasound in Medicine and Biology, 2019Co-Authors: Minwoo Shin, Yunjung Lim, Seok Hahn, Jinyoung BangAbstract:The aim of this study was to evaluate the diagnostic potential of real-time sonoelastography (RSE) in Medial Epicondylitis by comparing clinically diagnosed patients and patients without Medial elbow pain. From July 2016 to December 2017, gray-scale sonographic findings (swelling, cortical irregularity, hypo-echogenicity, calcification and tear), color Doppler findings (hyperemia) and sonoelastographic findings (elastographic grade on a 3-point visual scale and strain ratio from two regions of interest) for 63 elbows of 56 patients were compared. Twenty-four patients with 29 imaged elbows were clinically diagnosed with Medial Epicondylitis, and 32 patients with 34 imaged elbows had no Medial elbow pain. Cortical irregularity, hypo-echogenicity, calcification, elastographic grade and strain ratio revealed significant differences (p < 0.05). Among these, strain ratio had the highest diagnostic performance (area under the curve: 0.985). Real-time sonoelastography, which can obtain both elastographic grade and strain ratio, is valuable as a supplementary tool in the diagnosis of Medial Epicondylitis.
Michael C Ciccotti - One of the best experts on this subject based on the ideXlab platform.
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open treatment of Medial Epicondylitis
Techniques in Orthopaedics, 2006Co-Authors: Michael Schwartz, Michael C CiccottiAbstract:Summary: Although limited literature exists on Medial Epicondylitis of the elbow, this disorder is an injury affecting many professionals and athletes at every level, especially throwing athletes. Care must be taken in diagnosing Medial Epicondylitis to distinguish it from other possible pathologies of the Medial elbow, which may exist concurrently. The large majority of patients diagnosed with Medial Epicondylitis will respond to a well-structured, nonsurgical program. However, patients with persistent or recurring symptoms can be treated surgically, which yields high patient satisfaction and ultimately a reliable return to preinjury levels of activity.
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diagnosis and treatment of Medial Epicondylitis of the elbow
Clinics in Sports Medicine, 2004Co-Authors: Michael Schwartz, Michael C CiccottiAbstract:Although limited literature exists on Medial Epicondylitis of the elbow, this disorder is an injury affecting many athletes at every level, especially throwing athletes. Care must be taken in diagnosing Medial Epicondylitis to distinguish it from other possible pathologies of the Medial elbow, which may exist concurrently. The large majority of patients diagnosed with Medial Epicondylitis will respond to a well-structured, nonsurgical program; however, patients with persistent or recurring symptoms can be treated surgically, which yields high patient satisfaction and ultimately a reliable return to preinjury levels of activity.
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lateral and Medial Epicondylitis of the elbow
Journal of The American Academy of Orthopaedic Surgeons, 1994Co-Authors: Frank W Jobe, Michael C CiccottiAbstract:Epicondylitis of the elbow involves pathologic alteration in the musculotendinous origins at the lateral or Medial epicondyle. Although commonly referred to as "tennis elbow" when it occurs laterally and "golfer's elbow" when it occurs Medially, the condition may in fact be caused by a variety of sports and occupational activities. The accurate diagnosis of these entities requires a thorough understanding of the anatomic, epidemiologic, and pathophysiologic factors. Nonoperative treatment should be tried first in all patients, beginning with an initial phase of rest, ice, nonsteroidal anti-inflammatory agents, and possibly corticosteroid injection. A second phase includes coordinated rehabilitation, consisting of range-of-motion and strengthening exercises and counterforce bracing, as well as technique enhancement and equipment modification if a sport or occupation is causative. Nonoperative treatment has been deemed highly successful, yet the few prospective reports available suggest that symptoms frequently persist or recur. Operative treatment is indicated for debilitating pain that is diagnosed after the exclusion of other pathologic causes for pain and that persists in spite of a well-managed nonoperative regimen spanning a minimum of 6 months. The surgical technique involves excision of the pathologic portion of the tendon, repair of the resulting defect, and reattachment of the origin to the lateral or Medial epicondyle. Surgical treatment results in a high degree of subjective relief, although objective strength deficits may persist.