الفهرس 
? Incidence, epidemiology and aetiology of lateral epicondylitisOnly 14 pages are availabe for public view
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Abstract
Lateral epicondylitis (LE) is a non-inflammatory degenerative disease of the common extensor origin due to an overload repetitive microtrauma resulting in a process of immature reparative response and delayed tendon healing.
Lateral epicondylitis is characterized by ”angiofibroblastic hyperplasia” or non-inflammatory degeneration of Extensor Carpi Radialis Brevis (ECRB) or common extensor tendon together with cellular apoptosis, therefore the term ”tendinosis” has been recently adopted instead of the term ”tendinitis.
Diagnosis of LE is mainly clinical. Clinical picture include lateral elbow pain that is aggravated by activities involving wrist extension and gripping. Examination reveals tenderness at the lateral epicondyle together with pain on resisted wrist extension. Provocative tests can be of value in diagnosing LE, The standard provocative tests for LE are: Cozen’s, Mill’s and Maudsley’s tests.
It is very important to exclude conditions that may mimic LE before starting the plan of management such as cervical radiculopathy, osteochondritis dissecans and intra-articular foreign body.
There is a wide spectrum of treatment modalities such as rest, activity modification, stretching exercises, using of counterforce brace, NSAID, steroid injections, botulinum injections, PRP injection, shock wave therapy and as a last option surgical interference. However in some cases none of them is highly effective. Local corticosteroid (CS) injection has been a common treatment modality for LE. However because of the new concept of the disease pathogenesis, absence of long-term effect and its side effects, the validity of usage of CS has become debatable.
Hyaluronic acid (HA) (or “hyaluronan”, or “sodium hyaluronate preparation”) is a high molecular weight polysaccharide, one of the major components of articular cartilage and synovial fluid, showed encouraging results regarding its ability to promote tendon gliding, reduce adhesion formation, reduce the healing time and increase tenocytes viability and proliferation. It has shown good results in management of acute ankle sprain, rotator cuff tears and supraspinatus tendinosis.
Thus we hypothesized that HA could improve structural damage of the affected tendon, together with pain elimination thus can be used in the treatment of LE.
This study was conducted on 30 patients diagnosed with lateral epicondylitis. Diagnosis was based on detailed history taking and full clinical examination with particular attention to provocative tests (Cozen’s, Mill’s and Maudsley’s tests).