The “Scratch Test” involves scraping areas of suspected tendinosis in the surgical management of elbow epicondylitis. The authors studied tissue specimens from 19 cases of medial and lateral epicondylitis and found significant differences in histological characteristics between tendon tissue that was scraped and adjacent, normal appearing tissue.
The results of this study support the “Scratch Test” as an effective means of discriminating between tendinosis and normal appearing tendon tissue. Tendinosis is characterized by hypertrophic, plump, active fibroblasts, vascular hyperplasia, disorganized collagen, and occasional macrophages and lymphocytes. Normal tendon consists of sparse, spindle-shaped fibroblasts and tightly packed highly organized bundles of collagen.