Is it good to get an Elbow MRI to verify tendon tear has healed?

[Raul_SJ]

Was diagnosed with Tennis and Golfers Elbow. Elbow MRI indicated moderate tendon tear.

I avoided tennis 4+ months and did the stretching nd started to slowly come back to playing past few months. Thought it was healed but now pain is creeping back on the medial side.

Should I request MRI to verify tendon tear has healed?

History: Elbow pain, evaluate for lateral epicondylitis.

Findings:
No joint effusion

There is clustered intraosseous cystic change within the lateral humeral epicondyle measuring 0.9 x 0.7 cm.

Moderate tendinopathy with moderate grade partial tearing at the common extensor origin with surrounding formation...

Common flexor origin is normal. Radial and ulnar collateral ligaments are intact. Articular cartilage intact.
Biceps muscle and the biceps, brachialis and triceps tendon intact. Normal appearance of the ulnar nerve. No mass is seen in the cubital tunnel.

Impression:
1. Moderate grade partial tearing of the common extensor origin superimposed upon tendinosis.

2. Intraosseus ganglion within the lateral humeral epicondyle.​

 

[Say Chi Sin Lo]

Was diagnosed with Tennis and Golfers Elbow. Elbow MRI indicated moderate tendon tear.

I avoided tennis 4+ months and did the stretching nd started to slowly come back to playing past few months. Thought it was healed but now pain is creeping back on the medial side.

Should I request MRI to verify tendon tear has healed?

History: Elbow pain, evaluate for lateral epicondylitis.

Findings:
No joint effusion

There is clustered intraosseous cystic change within the lateral humeral epicondyle measuring 0.9 x 0.7 cm.

Moderate tendinopathy with moderate grade partial tearing at the common extensor origin with surrounding formation...

Common flexor origin is normal. Radial and ulnar collateral ligaments are intact. Articular cartilage intact.
Biceps muscle and the biceps, brachialis and triceps tendon intact. Normal appearance of the ulnar nerve. No mass is seen in the cubital tunnel.

Impression:
1. Moderate grade partial tearing of the common extensor origin superimposed upon tendinosis.

2. Intraosseus ganglion within the lateral humeral epicondyle.​

It never hurts (except for the wallet, unless you have a royalty's health insurance where they cover everything) to have a before and after image.

Now I'm no doctor, but as soon as I see the word tendinopathy, I feel for you man. I barely bat an eye to tendinitis, that's just good old and controllable inflammation. But if you have tendinopathy, you've had your inflammatory phase and it's gone beyond that. We're talking about degeneration of the tendon.

Also, ganglion cysts are correlated with joint degeneration as well. (No one knows why they form, but there's a correlation with degeneration of the joint)

Definitely consult your doctor. But if pain is returning, that's likely due to your degenerating tendon.

 

[heninfan99]

Sound like you'll have to pay out of your own pocket.

 

[ollinger]

Get out the wallet; doubt insurance will pay for an MRI that's so non-essential

 

[Raul_SJ]

Players often resume activity too early and do more (irreversible) damage. After conservative amount of rest, I felt fine and that's why I came back. Hence, I would think it's important to follow up with MRI to confirm the tendon has actually healed.

Many patients with tennis elbow report that their pain will often return despite wearing braces, stretching, ultrasound treatments or even getting cortisone injections. They begin to feel like they just have a “bad elbow” and try not to overuse or irritate it. In the last few years, researchers have been examining the way that we had typically treated tennis elbow and tried to come up with better treatment options that would give longer lasting relief.

First, it helps to understand what tennis elbow is. Patients with tennis elbow actually have a condition called lateral epicondilitis (now you can see why we call it tennis elbow!). This condition is degenerative in nature, causing little holes to develop in the tendons of the muscles along the outside of your elbow, causing pain. If you looked at the tendons under a microscope, it would look a little like swiss cheese. This degeneration occurs over a long period of time as you put extra wear & tear on the muscles. Most of the time, this extra wear & tear comes from improper ergonomics, having tight medial forearm muscles or poor shoulder posture.

The old treatment options such as bracing, ultrasound or shots, didn’t really solve the problem that was causing the degeneration. So the patient would feel better for a while and then the pain would return as soon as they returned to their normal lifestyle. Newer treatments are focusing on helping the tendons become strong again and removing the reason why they were getting worn out.

https://ducatchiropractic.com/2011/...bow-keep-coming-back-i-dont-even-play-tennis/

​

 

[ollinger]

. Hence, I would think it's important to follow up with MRI to confirm the tendon has actually healed.

Insurance companies don't think that way; MRIs are very expensive and they often deny them when there's a much better reason than confirming healing

 

[nvr2old]

Insurance companies don't think that way; MRIs are very expensive and they often deny them when there's a much better reason than confirming healing

Sad truth is that insurance companies really dictate and run medicine, not the doctors. Insurance companies dictate what tests they'll cover, meds they will ok etc etc. Want to reform medicine, then reform or do away with insurance company interference and let doctors directly treat patients with reasonable exams, tests, and treatment and cut out the insurance middlemen! Oh yeah and that way you could get your MRI to assess healing. (sorry for the diatribe!)

 

[jacob22]

Sad truth is that insurance companies really dictate and run medicine, not the doctors. Insurance companies dictate what tests they'll cover, meds they will ok etc etc. Want to reform medicine, then reform or do away with insurance company interference and let doctors directly treat patients with reasonable exams, tests, and treatment and cut out the insurance middlemen! Oh yeah and that way you could get your MRI to assess healing. (sorry for the diatribe!)

Unfortunately, unnecessary testing is part of why so much money is spent on healthcare. If you let the doctors manage themselves, you'll end up with more unnecessary tests, procedures, complications. The latest healthcare trend is value-based care, paying doctors for quality of care rather than fee for service.

No insurance company will pay for another MRI to see if your tendon has healed because it's not cost effective or found to be beneficial.

 

[scotus]

Players often resume activity too early and do more (irreversible) damage. After conservative amount of rest, I felt fine and that's why I came back. Hence, I would think it's important to follow up with MRI to confirm the tendon has actually healed.

Many patients with tennis elbow report that their pain will often return despite wearing braces, stretching, ultrasound treatments or even getting cortisone injections. They begin to feel like they just have a “bad elbow” and try not to overuse or irritate it. In the last few years, researchers have been examining the way that we had typically treated tennis elbow and tried to come up with better treatment options that would give longer lasting relief.

First, it helps to understand what tennis elbow is. Patients with tennis elbow actually have a condition called lateral epicondilitis (now you can see why we call it tennis elbow!). This condition is degenerative in nature, causing little holes to develop in the tendons of the muscles along the outside of your elbow, causing pain. If you looked at the tendons under a microscope, it would look a little like swiss cheese. This degeneration occurs over a long period of time as you put extra wear & tear on the muscles. Most of the time, this extra wear & tear comes from improper ergonomics, having tight medial forearm muscles or poor shoulder posture.

The old treatment options such as bracing, ultrasound or shots, didn’t really solve the problem that was causing the degeneration. So the patient would feel better for a while and then the pain would return as soon as they returned to their normal lifestyle. Newer treatments are focusing on helping the tendons become strong again and removing the reason why they were getting worn out.

https://ducatchiropractic.com/2011/...bow-keep-coming-back-i-dont-even-play-tennis/

​

I don't really see the need for mri. Even if your elbow were completely healed, tennis elbow can easily recur.

 

[toby55555]

Sad truth is that insurance companies really dictate and run medicine, not the doctors. Insurance companies dictate what tests they'll cover, meds they will ok etc etc. Want to reform medicine, then reform or do away with insurance company interference and let doctors directly treat patients with reasonable exams, tests, and treatment and cut out the insurance middlemen! Oh yeah and that way you could get your MRI to assess healing. (sorry for the diatribe!)

UK's NHS is no better for this sort of thing, trying to get a scan referral from a GP here is virtually impossible. I couldn't even get one for what turned out to be a slipped disk needing surgery; had to go private but at least then the NHS did the surgery (couldn't get out of that).

 

[Raul_SJ]

Yes, I know how insurance bureaucracies and approvals work.

But from a common sense medical perspective, it makes sense to verify the healing as clinical symptoms do not always correlate with MRI findings, i.e. one can feel
fine after resting for few months but tendon might still be torn.

Players often resume activity too soon and cause irreversible tendon damage.

 

[ollinger]

Yes, I know how insurance bureaucracies and approvals work.

But from a common sense medical perspective, it makes sense to verify the healing as clinical symptoms do not always correlate with MRI findings, i.e. one can feel
fine after resting for few months but tendon might still be torn.

Players often resume activity too soon and cause irreversible tendon damage.

it might make some sense, but not enough to justify the high cost of another MRI to an insurance company. As toby55555 noted, both in the US and elsewhere, MRIs are often denied even when there's a much better reason to do one than what you'd like to know. If it's that important to you, get that checkbook out. GIven the amount of healthcare rationing that already exists, I think an MRI to measure extent of healing is hard to justify.

 

[Curious]

Even if your elbow were completely healed, tennis elbow can easily recur.

Maybe not, if you get a nice and heavy, sub 60 stiffness rated racket.

 

[Curious]

Maybe not, if you get a nice and heavy, sub 60 stiffness rated racket.

Oops, the OP already uses a nice and heavy, flexible racket. Maybe the smallish 95 head size is the problem!