Elbow Joint

1. What is tennis elbow?

It is condition in which there is pain and inflammation at the outer point of elbow. Patients are not able to lift even the slightest weights, have poor grip and difficulty in gripping objects. Although the name of this condition is ‘Tennis Elbow’, it is seen in general population also and may not be necessarily due to injury.

2. What is the treatment?

The first action necessary is to stop activities that cause aggravation of the problem. There are other modalities including physiotherapy, medications which can help in this condition. Sometimes an injection can also help at the site. Rarely in some cases that do not respond to prolonged treatment, surgery may be needed.

3. Can I continue to do daily activities? Can I left weights?

Yes. Except for some activities that cause aggravation of the problem, people can continue with their daily activities. You can lift weights after complete pain relief and rehab.

4. Is this curable? My friend has got a recurrence after being pain-free for 6 months?

Yes this is completely curable. In some patients there may be a recurrence. Usually it is in patients who do not adhere completely to the treatment regime.

 

 

 

 

 

 

 

 

1. What is osteochrondritis dissecans?

In this condition the blood supply to a small part of the bone with the cartilage on top of it gets interrupted. This part of bone and cartilage becomes dead. In some patients the blood supply gets restored and the lesion heals. This is usually in adolescents and young patients. In older patients the dead bone and cartilage get separated and form loose body in the joint.

2. What are the symptoms?

There is pain and sometimes swelling in the elbow in the initial stages. There is pain in movements and tenderness at the spot of the lesion. If it heals then pain and swelling decrease slowly.

Later when a loose body forms, the elbow joint may get locked in one position. Such locking episodes may occur once or multiple times. These episodes are painful. Other patients may feel clicking inside the joint occasionally.

3. What are the investigations needed?

X-rays, MRI and if a loose body is seen then a CT scan may be required.

4. What is the treatment?

It depends on the stage of the disease. If there is a loose piece lying in the joint then the only option is arthroscopic surgery. There are two puncture holes around the elbow joint and the loose piece is extracted. If the defect left behind by the loose piece is small then only a small additional procedure is required. If the defect is large then there are other options that can be discussed with the doctor during consultation.

1. What is elbow joint synovitis?

Sometimes there is inflammation or infection in the elbow joint which

• Cannot be diagnosed by blood tests and radiological tests like MRI.
• Cannot be treated completely by medicines.

2. How do I know if I have synovitis?

Patients have pain in the elbow, which increases with all movements of the elbow, sometimes elbow is fixed in one position; with or without fever. If there is infection, the symptoms start and progress very rapidly within 1-2 days with very high-grade fever and patient is very unwell. Often patients with more chronic problems have undergone multiple MRI and other investigations without pain relief.

3. How can arthroscopy help in these cases?

In these cases an elbow arthroscopy is useful to obtain tissue directly from the elbow for diagnosis. Although this is not the treatment it does help to get a diagnosis. Elbow arthroscopy is also useful to remove the inflamed tissue or the infected tissue as a part of the whole treatment process.

4.What is the duration of hospital stay? Do I require any bed rest?

The stay in hospital is about 1 day. Rest is required till pain relief and then patient can start using the arm.

1. What is Elbow Joint Synovial Osteochondromatosis?

This condition is seen in young patients between the ages of 20-45 years. The inner lining of the elbow joint starts to abnormally produce excess cartilage and bone like tissue. Normally this lining produces a lubricating fluid. These cartilage-like loose bodies within the elbow joint initially irritate and then abrade the cartilage of the joint. Cartilage is the protective covering over the joint surface. Loss of this protective covering leads to arthritis and damage of the elbow joint.

2. What are the symptoms?

Patients have pain and swelling in the elbow, and other activities of daily living. In early cases patients are apparently normal but cannot walk long distances and complain of a particular heaviness of the elbow joint.

3. What is the treatment?

Elbow arthroscopy i.e surgery through small puncture wounds around the elbow is needed. All the loose bodies and the joint lining is removed. This surgery avoids the traditional method where a big incision was taken, splitting the muscles and doing the surgery.

4. What is the hospital stay and the recovery period?

The stay in hospital is 2-3 days and patients can start walking with walker as soon as pain is tolerable. Usually patients are able to get back to office within 2-3 weeks.

5. Is there a chance of recurrence?

Yes, rarely this condition may recur but there it can be treated.

6. Why does this condition occur?

The cause of this condition is not known. Many researchers have tried to find a cause but could not.

7. What are loose bodies?

These are free pieces of bone or cartilage, which lie within the elbow joint. They are like pebbles in a flowing river. They move within the joint with joint movement. A foreign body in the eye irritates the eye and the eye turns red and painful. Similarly a loose body in a joint irritates and over a long period of time causes destruction and arthritis of the joint.

8. How does a loose body come in the elbow joint?

Usually a loose body enters the elbow joint after a significant elbow joint injury like road accident or fall from height, which causes a fracture of either bone of the elbow joint. The other cause is synovial osteochondromatosis.

9. What are the symptoms and treatment for loose bodies?

The symptoms, treatment and recovery are similar to what has been given for synovial osteochondromatosis.