{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T10:06:37Z","timestamp":1779271597946,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T00:00:00Z","timestamp":1740355200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Lateral elbow pain, often attributed to lateral epicondylitis, presents diagnostic complexities. Lateral epicondylitis, or tennis elbow, is the most frequent cause of lateral elbow pain, but a differential diagnosis among all the potential causes of lateral elbow pain is not easy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To evaluate the rate of misdiagnoses in patients previously diagnosed with lateral epicondylitis, identify at-risk patient profiles, and determine sensitive clinical tests for a misdiagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Case series; Level of evidence, 4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A prospective analysis was conducted on 189 consecutive patients with a previous diagnosis of lateral epicondylitis and failed nonoperative treatment. According to medical history and a physical examination, patients were preliminarily classified into the typical or atypical lateral epicondylitis group. Atypical epicondylitis was defined as one of the following: atypical lateral pain location, history of trauma, limited range of motion (ROM), elbow swelling, negative Cozen test finding, and physical examination findings suggesting a misdiagnosis. Patients in the atypical group were further investigated for a potential lateral epicondylitis misdiagnosis using magnetic resonance imaging, computed tomography, and\/or analysis of intraoperative samples according to suspected underlying abnormalities. Univariate and logistic regression analyses were conducted to assess the risk of a misdiagnosis. A standardized diagnostic analysis was performed to evaluate the clinical tests used during the physical examination to identify misdiagnosed patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A misdiagnosis occurred in 21 of 189 (11%) patients. The most common misdiagnoses were posterolateral elbow instability in 6 patients; radial nerve compression and inflammatory osteoarthritis in 3 patients each; and osteochondritis dissecans, posterolateral plica, and primary osteoarthritis in 2 patients each. The variables associated with a misdiagnosis were young age (\u226430 years; odds ratio [OR], 66.90;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), history of trauma (OR, 17.85;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .0027), history of a limitation of ROM and\/or mechanical symptoms (OR, 16.68;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .0278), history of elbow swelling (OR, 14.32;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .0032), and number of corticosteroid injections (OR, 2.00;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .0007). Atypical lateral pain location highly predicted a misdiagnosis, with a sensitivity of 90.5%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>A misdiagnosis can occur in patients affected by longstanding lateral elbow pain. Young patients and patients with a history of elbow trauma, a limitation of ROM, swelling, corticosteroid injections, and atypical lateral pain should be highly suspected for a misdiagnosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465251319545","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T03:21:37Z","timestamp":1740367297000},"page":"1195-1201","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["When Lateral Epicondylitis Is Not Lateral Epicondylitis: Analysis of the Risk Factors for the Misdiagnosis of Lateral Elbow Pain"],"prefix":"10.1177","volume":"53","author":[{"given":"Davide","family":"Blonna","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Traumatology, Mauriziano Umberto I Hospital, Turin, Italy"},{"name":"University Hospital of Turin, Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7625-1688","authenticated-orcid":false,"given":"Norsaga","family":"Hoxha","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Mauriziano Umberto I Hospital, Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Greco","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Mauriziano Umberto I Hospital, Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina","family":"Rivoira","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Mauriziano Umberto I Hospital, Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide Edoardo","family":"Bonasia","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Mauriziano Umberto I Hospital, Turin, Italy"},{"name":"University Hospital of Turin, Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Rossi","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Mauriziano Umberto I Hospital, Turin, Italy"},{"name":"University Hospital of Turin, Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,2,24]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1053\/jars.2001.20096"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2011.06.018"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-023-05805-x"},{"key":"e_1_3_2_5_2","volume-title":"StatPearls","author":"Buchanan BK","year":"2023","unstructured":"Buchanan BK, Varacallo M. Lateral epicondylitis (tennis elbow). In: StatPearls. StatPearls Publishing; 2023."},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jses.2018.02.004"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2008.052738"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2007.036723"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcot.2021.101492"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e3181a68a040"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp15X687625"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1302\/2058-5241.5.200027"},{"issue":"3","key":"e_1_3_2_13_2","first-page":"156","article-title":"Radial tunnel syndrome, diagnostic and treatment dilemma","volume":"3","author":"Moradi A","year":"2015","unstructured":"Moradi A, Ebrahimzadeh MH, Jupiter J. Radial tunnel syndrome, diagnostic and treatment dilemma. 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