The effectiveness of magnetic resonance imaging for diagnosing lateral epicondylitis severity is controversial. We aimed to verify whether individual evaluations of the common extensor tendon and lateral collateral ligament would improve the severity diagnostic accuracy of magnetic resonance imaging for lateral epicondylitis. We obtained coronal images of the lateral elbow in three groups: healthy, clinically mild, and clinically severe. We used our scoring system for evaluation using combined and individual methods. We developed the receiver operating characteristic curve for diagnosis using the scores of the healthy and mild groups and that for severity diagnosis using the scores of the mild and severe groups. The scores, in decreasing value, were those of the severe, mild, and healthy groups, with a significant difference in both methods. The curve for diagnosis showed an area under the curve of 0.85 for the combined evaluation and 0.89 for the individual evaluation, without a significant difference between the methods (p = 0.23). The curve for severity diagnosis showed an area under the curve of 0.69 for combined and 0.81 for individual evaluation, with a significant difference between the methods (p = 0.046). Individual evaluation of the common extensor tendon and lateral collateral ligament improved the severity diagnostic accuracy of lateral epicondylitis.

Mobile magnetic resonance imaging (MRI) using a car is a recent advancement in imaging technology. Specifically, a car-mounted mobile MRI system is expected to be used for medical check-ups; however, this is still in the research stage. This study demonstrated the practicality of a small car-mounted mobile MRI in on-field screening for osteochondritis dissecans (OCD) of the humeral capitellum. In the primary check-up, we screened the throwing elbows of 151 young baseball players using mobile MRI and ultrasonography. We definitively diagnosed OCD at the secondary check-up using X-ray photography and computed tomography or MRI. We investigated the sensitivity and specificity of mobile MRI and ultrasonography for OCD. Six patients were diagnosed with OCD. The sensitivity was 83.3% for mobile MRI and 66.7% for ultrasonography, with specificity of 99.3% vs. 100%, respectively. One patient was detected using ultrasonography but was missed by mobile MRI due to poor imaging quality at the first medical check-up. Following this false-negative case, we replaced a damaged radio frequency coil to improve the image quality, and the mobile MRI could detect all subsequent OCD cases. Two patients were diagnosed by mobile MRI only; ultrasonography missed cases lacking subchondral bone irregularity, such as a healing case, and an early-stage case. Mobile MRI could screen for OCD from the very early stages through the healing process and is therefore a practical tool for on-field screening.

Background: Lateral epicondylitis is a self-limited disease and refractory condition; thus providing optimal treatment is challenging. This study investigated a method for predicting cases that would not improve sufficiently under a wait-and-see policy using clinical indicators obtained during the initial consultation. Methods: Twenty-two patients with lateral epicondylitis prescribed a resting orthosis and followed up for 6 months were included. Grip strength ratios for affected/unaffected side; quick disabilities of the arm, shoulder, and hand (QuickDASH) scores were measured at 6-week intervals. Receiver operating characteristic curves for predicting refractory cases were created from the initial measurement items to determine the cut-off values and prediction accuracy. Results: The 6-month post-treatment QuickDASH scores for the 14 improved patients and 8 refractory patients were 2.3 ± 4.7 and 25.9 ± 15.4, respectively. Grip strength ratios significantly predicted refractoriness risk with a 0.54 cut-off value. The QuickDASH scores significantly predicted refractoriness risk with a 30-point cut-off value. Meeting either of these cutoff values achieved a sensitivity of 1.0 for predicting refractoriness. Conclusions: The patients with a grip strength ratio ≤ 0.5 on the affected side or a QuickDASH score ≥ 30 at initial consultation continued having symptoms 6 months after conservative treatment.