Overuse injury of the hand, especially finger flexor tendons which originate in the medial humoral epicondyle

Aetiology

• Can be caused by repetitive strain or degeneration of the common flexor origin
• Less common than lateral epicondylitis

Clinical features

Symptoms

• Medial elbow pain with a tender point over the origin of the flexors at the medial epicondyle
• Pain is aggravated by wrist flexion and pronation
• Pain worse upon grasping e.g. opening a jar

Signs

• Flex elbow to 90° in supination, pain produced when wrist flexed against resistance

Investigations

• Mainly clinical
• USS and MRI may be required where diagnosis uncertain
• Nerve conduction study: should be carried out if there are any nerve symptoms

Management

• Conservative - rest, NSAIDs, physio, injection of LA and steroids
  • Injection carries a risk of injury to the ulnar nerve
• Surgical release for refractory cases