This anatomic and clinical study examines the relationship between a characteristic pattern of bone formation and the clinical entity of tennis elbow. The authors examined 1232 elbow and found that 16% of the skeletons had a characteristic pattern or spur formation at the anterolateral aspect of the humerus corresponding to the insertion of the capsular ligamentous structures on the anterolateral aspect of the humerus. The authors then performed coronal reconstructions by computed tomography on 20 patients with the clinical entity of tennis elbow and found that 60% of these patients had this characteristic bony finding. The authors postulate that these findings may be an associated cause of tennis elbow.
This study raises the issue of whether a bony excrescence may be an associated finding with lateral epicondylitis. It is an interesting concept but no cause and effect can be concluded. Furthermore, the identification of a spur in patients and cadavers was made with different techniques (visualization versus imaging). A comparative evaluation of CT scans in asymptomatic elbows (or the contralateral elbow in unilateral cases) would thus have been useful.