What is the diagnostic approach and treatment for suspected lateral epicondylitis (tennis elbow) presenting with elbow pain radiating down the forearm, erythema, and no skin lesions?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: March 27, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Differential Diagnosis for Elbow Pain Radiating Down the Forearm

Single Most Likely Diagnosis

  • Lateral Epicondylitis: This condition, also known as tennis elbow, is characterized by pain on the outer part of the elbow, which can radiate down the forearm. It is often caused by repetitive motions and strain on the forearm extensors. The symptoms and presentation described align closely with lateral epicondylitis, making it the most likely diagnosis.

Other Likely Diagnoses

  • Medial Epicondylitis: Known as golfer's elbow, this condition causes pain on the inner part of the elbow, which can also radiate down the forearm. Although the pain location differs from the described case, it's a common condition related to repetitive strain and should be considered.
  • Radial Tunnel Syndrome: This condition involves compression of the radial nerve and can cause pain in the back of the hand and the forearm. It might be considered if the pain pattern and other symptoms align more closely with nerve compression rather than tendon inflammation.
  • Olecranon Bursitis: Inflammation of the bursa at the elbow can cause pain and swelling, which might be confused with lateral epicondylitis if the swelling is not prominent or if the patient has limited mobility.

Do Not Miss Diagnoses

  • Fracture or Dislocation: Although less likely given the description of pain from repetitive motions, it's crucial to rule out any acute traumatic injuries, especially if there was a recent fall or direct blow to the elbow.
  • Infection (Osteomyelitis or Septic Arthritis): Infections in the bone or joint can present with pain, erythema, and swelling. These conditions are medical emergencies and require prompt diagnosis and treatment.
  • Neoplastic Processes: Tumors, either benign or malignant, can cause bone pain and should be considered, especially if the pain is persistent and not clearly related to activity.

Rare Diagnoses

  • Entrapment Neuropathies (Other Than Radial Tunnel Syndrome): Conditions like pronator teres syndrome or posterior interosseous nerve syndrome can cause forearm pain but are less common.
  • Gout or Pseudogout: These conditions can cause sudden, severe joint pain and swelling, including in the elbow, though they are less common in this joint compared to others like the big toe.
  • Rheumatologic Conditions: Conditions such as rheumatoid arthritis or lupus can cause elbow pain and should be considered, especially if there are systemic symptoms or a history of autoimmune disease.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.