Which scans are best for lateral elbow pain

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When it comes to radiological tests for lateral elbow pain (lateral epicondylitis or tennis elbow), both ultrasound and magnetic resonance imaging (MRI) can provide valuable information. However, the most reliable radiological test may depend on the specific clinical scenario and the information being sought.


  1. Ultrasound is commonly used as an initial imaging modality for lateral elbow pain due to its accessibility, cost-effectiveness, and ability to provide real-time imaging. Ultrasound can effectively visualize tendons, ligaments, and other soft tissues around the elbow joint. It can help identify tendon abnormalities, such as thickening, tears, or calcifications, which are characteristic of lateral epicondylitis.

Advantages of Ultrasound:

  • Real-time imaging allows dynamic assessment of the affected area.
  • Cost-effective and widely available.
  • Can help guide interventional procedures, such as injections or needle aspiration.

Limitations of Ultrasound:

  • Operator-dependent; the reliability of the ultrasound scan can vary depending on the expertise and experience of the sonographer or clinician performing the examination.
  • Limited visualization of deeper structures compared to MRI.
  • Some structural abnormalities may not be clearly visualized, especially in cases where the pathology is more extensive or complex.


  1. MRI provides detailed images of the soft tissues, bones, and joints around the elbow. It can offer multiplanar views and high-resolution images, allowing for a comprehensive evaluation of the elbow joint and surrounding structures. MRI is particularly useful when there is a suspicion of other pathologies or when a more comprehensive assessment is required.

Advantages of MRI:

  • Excellent visualization of soft tissues, including tendons, ligaments, and joint structures.
  • Can provide detailed information about the extent and severity of pathology.
  • Useful for evaluating other possible causes of lateral elbow pain, such as joint or nerve-related issues.

Limitations of MRI:

  • Higher cost compared to ultrasound.
  • Not always readily available and may require scheduling and longer wait times.
  • Limited ability to assess real-time dynamic changes.

In summary, both ultrasound and MRI have their advantages and limitations in diagnosing and assessing lateral elbow pain. Ultrasound is often preferred as an initial imaging modality due to its accessibility and ability to evaluate specific tendon abnormalities associated with lateral epicondylitis. MRI is typically reserved for cases where a more comprehensive assessment or evaluation of other potential causes is necessary.

Ultimately, the choice between ultrasound and MRI depends on the individual patient’s clinical presentation, the specific diagnostic questions, and the expertise and resources available in the healthcare setting. Consulting with a qualified healthcare professional will help determine the most appropriate radiological test based on your specific needs.

Please note that this information is provided as a general guideline, and individual circumstances may vary