The Elbow

Cystic swelling between tendon and joint

A chronically irritated tendon may form a cystic swelling between the lateral epicondyle, the radio humeral joint and the extensor radialis tendon.

This space-occupying cyst then gives rise to a few degrees limitation of the passive extension of the elbow. The endfeel is rather soft.

Diagnosis
A type II tenniselbow is complicated by a lightly limited extension.
The end feel is soft and not springy as in a loose body
Palpation of the tendon reveals a cystic thickening deeply under the tendon, level with the radio-humeral joint.

Treatment
Infiltrations with triamcinolone as in a classical tennis elbow / evacuation of the fluid before the infiltration taking place is strongly advised.
Deep transverse frictions and Mill's manipulation are contra-indicated.