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Journal of Hand Surgery (British and European Volume)
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*Elbow Injuries and Disorders
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Articles

Wrist Extensor Muscle Pathology in Lateral Epicondylitis

B.-O. LJUNG
R. L. LIEBER
J. FRIDÉN

From the Departments of Hand Surgery, Stockholm Söder Hospital, Stockholm and Sahlgrenska University Hospital, Göteborg, Sweden

Correspondence: B-O. Ljung MD, Department of Hand Surgery, Stockholm Söder Hospital, S-118 83 Stockholm, Sweden. E-mail: bjorn-ove.ljung{at}sos.ki.se

The morphology of the extensor carpi radialis brevis (ECRB) muscle was investigated in 20 patients with longstanding lateral epicondylitis. Muscle biopsies were obtained from the proximal or distal portion of the ECRB and analysed by enzyme- and immunohistochemical methods. Morphological abnormalities were significantly more frequent in patients than controls and included moth-eaten fibres, fibre necrosis and signs of muscle fibre regeneration as well as higher percentages of the fast-twitch oxidative (type 2A) fibre type. Changes were equally distributed proximally and distally. It is concluded that these changes, directly or indirectly, may reflect the cumulative effect of mechanical and/or metabolic overload and that decreased muscular performance in patients with lateral epicondylitis may be due to both elbow pain and physical damage to the ECRB muscle.

Journal of Hand Surgery (British and European Volume), Vol. 24, No. 2, 177-183 (1999)
DOI: 10.1054/JHSB.1998.0178
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