Which tests are commonly used to assess lateral epicondylitis?

Which tests are commonly used to assess lateral epicondylitis?

• A. Tinel's sign
• B. Phalen's test
• C. Mill's test, Maudsley's test, and Cozen's test
• D. Finkelstein's test

Answer: (C)

Lateral epicondylitis is caused by strain of the common extensor tendon origin at the lateral epicondyle, especially the extensor carpi radialis brevis. Tests that reproduce pain by loading that tendon help confirm this condition. Mill's test works by stressing the wrist flexors, which lengthens and loads the common extensor tendon when the elbow is extended, forearm pronated, and the wrist passively flexed; pain over the lateral epicondyle suggests tendinopathy of the origin. Maudsley’s test targets the same area by having the patient extend the middle finger against resistance; this specific resisted action loads the extensor tendon at its origin, producing reproducible lateral elbow pain if the tendon is irritated. Cozen’s test takes a more active approach: the patient makes a fist with the thumb tucked in, the forearm is pronated, and the clinician resists wrist extension; pain at the lateral epicondyle during this resistance also points to extensor tendon pathology. Other tests mentioned address different conditions: Tinel’s sign at the elbow relates to ulnar nerve irritation, Phalen’s test screens for median nerve compression at the carpal tunnel, and Finkelstein’s test detects De Quervain’s tenosynovitis. These do not specifically stress the common extensor origin, so they aren’t used to assess lateral epicondylitis.

Lateral epicondylitis is caused by strain of the common extensor tendon origin at the lateral epicondyle, especially the extensor carpi radialis brevis. Tests that reproduce pain by loading that tendon help confirm this condition.

Mill's test works by stressing the wrist flexors, which lengthens and loads the common extensor tendon when the elbow is extended, forearm pronated, and the wrist passively flexed; pain over the lateral epicondyle suggests tendinopathy of the origin. Maudsley’s test targets the same area by having the patient extend the middle finger against resistance; this specific resisted action loads the extensor tendon at its origin, producing reproducible lateral elbow pain if the tendon is irritated. Cozen’s test takes a more active approach: the patient makes a fist with the thumb tucked in, the forearm is pronated, and the clinician resists wrist extension; pain at the lateral epicondyle during this resistance also points to extensor tendon pathology.

Other tests mentioned address different conditions: Tinel’s sign at the elbow relates to ulnar nerve irritation, Phalen’s test screens for median nerve compression at the carpal tunnel, and Finkelstein’s test detects De Quervain’s tenosynovitis. These do not specifically stress the common extensor origin, so they aren’t used to assess lateral epicondylitis.