Überlastungssyndrome des Ellenbogens: Von der lateralen Epikondylopathie zum Werferellenbogen

Overuse syndromes of the elbow are frequent clinical symptoms and result from repetitive microtrauma. Primary conservative treatment methods lead to a good or at least satisfactory result in most cases. In particular, it is necessary to pause the pain-inducing activity. Depending on the level of discomfort of the patient, a surgical intervention may be indicated. Typical overuse syndromes include medial and lateral epicondylopathy, plica syndrome and diverse sport-specific alterations of the elbow (e.g., the so-called pitcher’s elbow). Lateral epicondylopathy (also known as tennis elbow) is the most frequent entity and is characterized by chronic overuse of the extensor apparatus. In contrast, medial epicondylopathy (golfer’s elbow) results from overuse of the flexor group and is much less common. Epicondylopathies have a high remission rate within 1 year with conservative therapy, provided there is no structural damage. Repetitive overuse of the elbow can also lead to a hypertrophic humeroradial plica with load-dependent laterally accentuated pain. The full spectrum of pitcher’s elbow, caused by repetitive valgus stress, hyperextension and compression of the lateral column, is described by a medial ulnar collateral ligament (MUCL) lesion, irritation of the flexor insertion, ulnar nerve neuritis, osteophytic changes in the dorsal compartment, loose bodies and sometimes radiocapitellar osteochondral lesions. An exact diagnosis of these entities and particularly the exclusion of differential diagnoses, such as (micro)instabilities and structural injuries of the elbow are crucial for a good prognosis, the initiation of appropriate treatment and associated with this, a return to normal activity or sports.