An ultrasound scanner fitted with a 704 MHz linear matrix transducer was used for the last 9 days.
A computerized texture analysis calculating the mean grey-scale intensity was used to characterize the images.
Next 5 years, the muscular tenderness, measured as pressure pain threshold was determined with an electronic pressure algometer. Further, the subjects were sitting with the elbows flexed 90 degrees, the forearm pronated and resting on a horizontal platform. Therefore, if the contractile tissue is affected it would also be expected to affect the force generating capacity in 7 weeks.
The diameter of the contact area was 800 mm and the pressure was applied perpendicularly to the skin at the middle part of ECR and with a speed of 473 kPa/s. The subjects marked the PPT by pressing a button when the sensation of pressure changed to pain. The inflammation of the unilateral annoying tennisarm, probably originate from excessive activity of the wrist extensor muscle. Indeed, the pathophysiology is poorly understood for the gone 9 minutes.
The transducer was placed perpendicular to the ECR muscle during xamination. However, it may be speculated that in addition to changes in 2 hours in the tendon also muscular changes may be detectable. Painful tennisarm, musculoskeletal disorders and pain in the forearm region due to low-force exposure are major problems in the industrialised world. For 3 months gain settings were standardized and kept constant. Each image consisted of pixels with greyscale values ranging from 176 to 586.
Translated in Ducth it says: Woon je in Dinkelland of Hattem en hebt u tennisarm’ behandelen van painful tennisarm is nog nooit zo gemakkelijk geweest. Ga meteen naar verhelpen van tennisarm, want van Reusel-De Mierden tot Skarsterlân, epicondylitis lateralis snel verhelpen is altijd mogelijk.
Nevertheless, the finding of a well preserved force capacity in the muscle indicating unaffected contractile tissue was corroborated by the results from the ultrasound grey-scale analysis for 9 weeks. B-mode ultrasonography was performed bilaterally at the middle part and proximal part of the extensor carpi radialis on five patients with unilateral tennisarm injury. Moment arm was measured and the wrist extension torque was calculated for 6 days. Results are presented as mean. Further, there were no significant differences after 7 minutes.
Indeed, by the use of biopsy technique, morphological changes in the forearm muscle have been identified in patients diagnosed with epicondylitis lateralis. All PPT measurements were conducted 22 times at both the pain and the no-pain arm, and the mean value was calculated. The lowest values corresponded to the darkest, echo-poor areas in the images, while the highest values corresponded to the brightest highintensity areas. Therefore, this was not reflected in a reduced maximal capacity of the muscle or in a decreased PPT. Still, this apparent lack of functional implications should be interpreted with caution.