Snapshot A 46-year-old man presents to his primary care physician for right-sided elbow pain. He describes the pain as sharp and worsens when performing arm curls or playing golf. He denies any direct trauma to the elbow. On physical exam, there is tenderness upon palpation of the medial elbow. Pain is elicited with resisted wrist flexion while the elbow is fully extended. Introduction Clinical definition an overuse syndrome that results in pain in the myotendinous junction between the wrist flexors and medial epicondyle also known as "golfer's elbow" Epidemiology Incidence it is less common than lateral epicondylitis more common in activities that result in repetitive wrist flexion forearm pronation Demographics typically between 40-60 years of age Etiology Microtrauma and degeneration of the flexor tendons A single traumatic event such as a direct blow to the medial elbow sudden extreme eccentric contraction Pathoanatomy the medial epicondyle is the bony origin for the wrist flexors and involve the pronators teres muscle flexor carpi radialis muscle repetitive wrist flexion and forearm pronation activities results in an angiofibroblastic tendinosis Presentation Symptoms pain in the medial elbow worsened with wrist flexion and forearm pronation pain onset is typically insidious Physical exam tenderness at the medial epicondyle pain upon resisted wrist flexion performed with the elbow extended pain upon passive wrist extension performed with the elbow extended Imaging Radiography performed in recalcitrant cases Studies Making the diagnosis a clinical diagnosis Differential Lateral epicondylitis distinguishing factor patients present with lateral elbow pain Treatment Conservative activity modification indication an initial intervention performed in all patients physical therapy indication an initial intervention performed in all patients Operative orthopedic surgery indication typically performed in patients who failed physical therapy for 4-6 months Complications Functional disability Prognosis May be self-limited