Lateral epicondylitis — SCE Rheumatology MCQ

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EasyOsteoarthritis and Soft Tissue RheumatologyLateral epicondylitisSCE Rheumatology

A 47-year-old office worker has lateral elbow pain worse gripping and lifting a kettle. Examination shows tenderness over the lateral epicondyle and pain on resisted wrist extension. There is no joint swelling or systemic disease. What is the most appropriate management?

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Correct answer: D — Education and physiotherapy-based exercise

Explanation lettering: B = shown as A · C = shown as B · A = shown as C

Advice, activity modification and physiotherapy-based exercise is best because lateral epicondylitis is managed initially with education, load modification and physiotherapy-based strengthening. A is less suitable because methotrexate is for inflammatory arthritis; B is less suitable because high-dose prednisolone is not appropriate; C is less suitable because prolonged casting risks stiffness and weakness; E is less suitable because elbow replacement is not indicated for uncomplicated tendinopathy. Clinical pearl: tendinopathy management is usually graded loading rather than complete rest.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/musculoskeletal-conditions