Bilateral welling anconeous muscle with hypernemia

[Xue Heng]

Hi, Steve. Here is a case that confused me.
The patient was a 45-year-old female, with bilateral posterior lateral elbow pain fow 2 months.
No obvious history of overuse or rheumatologic diseases.
She was clinically diagnosed as tennis elbow and treated with NSAIDs, but no obvious improvement was achieved.
The point with maximum tenderness corresponded to anconeous muscle.
B-mode US showed a little bit swelling with no obvious change in the echotexture.
However, color Doppler US showed significant increased blood flow.
CEO and PIN were normal.
How can we explain the findings of US? And what might cause these findings?
Thank you, Steve.

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[Stephen Bird]

Hi Xue,

What an unusual finding,

I agree the muscle is large and hyper vascular,

The echo texture looks normal although it might be slightly less echogenic overall than I would expect.

Is there a history of overuse of the muscle from repetitive work or sporting activity like badminton for example?

I am thinking along the lines of a myositis / Delayed oneset muscle soreness spectrum of disease here.

Steve

[Xue Heng]

Thank you for helping me everytime, Steve.

[Stephen Bird]

Hi Xue,,

Was there a history of overuse for that particular muscle?

Steve

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