Skeletal radiology · 2026
Prevalence of ultrasound-detected changes in the common extensor tendon of the elbow in asymptomatic amateur senior tennis players: associations with dominant arm and backhand technique.
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Crema Michel D, Guillard Vincent, Levavasseur Guillaume, Li Ling, Montalvan Bernard
Аннотация
OBJECTIVE: To assess the prevalence of ultrasound-detected changes in the common extensor tendon (CET) and their association with arm dominance and backhand technique in asymptomatic tennis players.
MATERIALS AND METHODS: Senior tennis players competing in the French National Tennis Championship who consented to clinical and ultrasound examination of their elbows were included. Clinical evaluation consisted of the Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire, palpation of the lateral epicondyle, and the Cozen and Maudsley tests. Ultrasound assessment of the CET focused on detecting morphological changes (including tears) and evaluating tendon vascularization using Doppler imaging. Logistic regression was employed to analyze the relationships between ultrasound-detected CET changes and arm dominance (dominant vs. non-dominant elbow) as well as backhand technique (one-handed vs. two-handed). Associations between CET morphology and PRTEE scores were also examined.
RESULTS: Among 102 asymptomatic players, 60 (58.8%) had at least one ultrasound-detected morphological abnormality of the CET, most frequently in the dominant elbow (47/60). Tendon tears were identified in 21 players, predominantly affecting the dominant side (17/21). We found a strong association of changes in CET with the dominant elbow, including tendon tears. No significant relationship was found between CET morphological changes and backhand technique. Abnormal vascularization of the CET was infrequent in this population. Additionally, no significant differences in mean PRTEE scores were observed between players with normal and abnormal CET morphology.
CONCLUSION: Morphological changes in the CET were frequent in asymptomatic senior tennis players. These changes were strongly associated with the dominant arm but not with backhand technique.
MATERIALS AND METHODS: Senior tennis players competing in the French National Tennis Championship who consented to clinical and ultrasound examination of their elbows were included. Clinical evaluation consisted of the Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire, palpation of the lateral epicondyle, and the Cozen and Maudsley tests. Ultrasound assessment of the CET focused on detecting morphological changes (including tears) and evaluating tendon vascularization using Doppler imaging. Logistic regression was employed to analyze the relationships between ultrasound-detected CET changes and arm dominance (dominant vs. non-dominant elbow) as well as backhand technique (one-handed vs. two-handed). Associations between CET morphology and PRTEE scores were also examined.
RESULTS: Among 102 asymptomatic players, 60 (58.8%) had at least one ultrasound-detected morphological abnormality of the CET, most frequently in the dominant elbow (47/60). Tendon tears were identified in 21 players, predominantly affecting the dominant side (17/21). We found a strong association of changes in CET with the dominant elbow, including tendon tears. No significant relationship was found between CET morphological changes and backhand technique. Abnormal vascularization of the CET was infrequent in this population. Additionally, no significant differences in mean PRTEE scores were observed between players with normal and abnormal CET morphology.
CONCLUSION: Morphological changes in the CET were frequent in asymptomatic senior tennis players. These changes were strongly associated with the dominant arm but not with backhand technique.