{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T17:13:14Z","timestamp":1762017194491},"reference-count":23,"publisher":"BMJ","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Occup Environ Med"],"published-print":{"date-parts":[[2007,11]]},"abstract":"<jats:sec><jats:title>Objectives:<\/jats:title><jats:p>To present data on pain and physical findings from the elbow region, and to discuss the role of diagnostic criteria in epidemiological studies of epicondylitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>From a cohort of computer workers a subgroup of 1369 participants, who reported at least moderate pain in the neck and upper extremities, were invited to a standardised physical examination. Two independent physical examinations were performedone blinded and one not blinded to the medical history. Information concerning musculoskeletal symptoms was obtained by a baseline questionnaire and a similar questionnaire completed on the day of examination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>349 participants met the authors criteria for being an arm case and 249 were elbow cases. Among the 1369 participants the prevalence of at least mild palpation tenderness and indirect tenderness at the lateral epicondyle was 5.8. The occurrence of physical findings increased markedly by level of pain score. Only about one half with physical findings fulfilled the authors pain criteria for having lateral epicondylitis. A large part with physical findings reported no pain at all in the elbow in any of the two questionnaires, 28 and 22, respectively. Inter-examiner reliability between blinded and not blinded examination was found to be low kappa value 0.340.40.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p>Very few with at least moderate pain in the elbow region met common specific criteria for lateral epicondylitis. The occurrence of physical findings increased markedly by level of pain score and the associations were strongest with pain intensity scores given just before the examination. Physical signs were commonly found in subjects with no pain complaints. No further impact was achieved if the physical examination was not blinded to the medical history. Furthermore, the authors propose that pain, clinical signs and disability are studied as separate outcomes, and that the diagnoses of lateral epicondylitis should be used only for cases with classical signs of inflammation reflected by severe pain, which for example conveys some disability.<\/jats:p><\/jats:sec>","DOI":"10.1136\/oem.2005.026260","type":"journal-article","created":{"date-parts":[[2007,5,24]],"date-time":"2007-05-24T00:46:09Z","timestamp":1179967569000},"page":"776-781","source":"Crossref","is-referenced-by-count":16,"title":["The role of physical examinations in studies of musculoskeletal disorders of the elbow"],"prefix":"10.1136","volume":"64","author":[{"given":"Ann Isabel","family":"Kryger","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina Funch","family":"Lassen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johan Hviid","family":"Andersen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2007,5,23]]},"reference":[{"key":"2024052223164892000_64.11.776.1","doi-asserted-by":"crossref","first-page":"197","DOI":"10.5271\/sjweh.722","article-title":"Development of neck and hand-wrist symptoms in relation to duration of computer use at work.","volume":"29","author":"Jensen","year":"2003","journal-title":"Scand J Work Environ Health"},{"key":"2024052223164892000_64.11.776.2","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.10133"},{"key":"2024052223164892000_64.11.776.3","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.10066"},{"key":"2024052223164892000_64.11.776.4","doi-asserted-by":"publisher","DOI":"10.1136\/oem.60.11.e14"},{"key":"2024052223164892000_64.11.776.5","doi-asserted-by":"crossref","first-page":"399","DOI":"10.5271\/sjweh.828","article-title":"Neck and shoulder symptoms and disorders among Danish computer workers.","volume":"30","author":"Brandt","year":"2004","journal-title":"Scand J Work Environ Health"},{"key":"2024052223164892000_64.11.776.6","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.20081"},{"key":"2024052223164892000_64.11.776.7","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.10024"},{"key":"2024052223164892000_64.11.776.8","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1002\/ajim.4700240605","article-title":"Musculoskeletal disorders of the neck and upper limb among sewing machine operators: a clinical investigation.","volume":"24","author":"Andersen","year":"1993","journal-title":"Am J Ind Med"},{"key":"2024052223164892000_64.11.776.9","doi-asserted-by":"publisher","DOI":"10.1136\/oem.57.8.528"},{"key":"2024052223164892000_64.11.776.10","doi-asserted-by":"publisher","DOI":"10.1016\/S0049-0172(03)00129-X"},{"key":"2024052223164892000_64.11.776.11","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0274(200004)37:4<423::AID-AJIM12>3.0.CO;2-W"},{"key":"2024052223164892000_64.11.776.12","doi-asserted-by":"publisher","DOI":"10.1136\/ard.61.12.1103"},{"key":"2024052223164892000_64.11.776.13","doi-asserted-by":"publisher","DOI":"10.1053\/jhsu.1999.jhsu24a0185"},{"key":"2024052223164892000_64.11.776.14","doi-asserted-by":"publisher","DOI":"10.1097\/01.BRS.0000089685.55629.2E"},{"key":"2024052223164892000_64.11.776.15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5271\/sjweh.637","article-title":"Criteria document for evaluating the work-relatedness of upper-extremity musculoskeletal disorders.","volume":"27","author":"Sluiter","year":"2001","journal-title":"Scand J Work Environ Health"},{"key":"2024052223164892000_64.11.776.16","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1136\/oem.55.4.264","article-title":"Suveillance case definitions for work related upper limb pain syndromes.","volume":"55","author":"Harrington","year":"1998","journal-title":"Occup Environ Med"},{"key":"2024052223164892000_64.11.776.17","unstructured":"McConnell S Beaton DE Bombardier C . The DASH Outcome Measure Users Manual. Toronto, Ontario: Institute for Work & Health, 1999."},{"key":"2024052223164892000_64.11.776.18","first-page":"37","article-title":"A coefficient of agreement for nominal scales.","volume":"20","author":"Cohen","year":"1960","journal-title":"Educ Psychol"},{"key":"2024052223164892000_64.11.776.19","unstructured":"Fleiss JL . Statistical methods for rates and proportions. Second edition. 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