Type of Article : Original Article

Year: 2014 | Volume 2 | Issue 6 | Page No. 815-823

Date of Publication: 11-12-2014

DOI: 10.16965/ijpr.2014.699

DIAGNOSTIC ACCURACY OF PROVOCATIVE TESTS IN LATERAL EPICONDYLITIS  

G Saroja *¹, Antony Leo Aseer P ², Venkata Sai P M ³.  

*¹Faculty of physiotherapy, Sri Ramachandra University, Chennai, Tamil Nadu, India.
² Reader in physiotherapy, Sri Ramachandra University, Chennai, Tamil Nadu, India.
³ Professor & Head in Radiology, Sri Ramachandra University, Chennai, Tamil Nadu, India.

Corresponding author: P. Antony Leo Aseer, Reader in Physiotherapy, Sri Ramachandra University, Chennai-600 116. Tamil Nadu, India.
E-Mail: antonyleo@yahoo.com

Abstract:

The aim of the present study was to analyze the diagnostic accuracy of the commonly used provocative tests in the diagnosis of lateral epicondylitis (LE). Cozen’s test, Mills test and Maudsley test are most widely used. Till date no studies have been reported on the diagnostic accuracy of these tests. Musculoskeletal ultrasonography serves as a gold standard tool in the diagnosis of LE. Thirty subjects participated in the study. Baseline measurements of pain severity, elbow joint mobility, hand grip strength and three provocative tests were recorded by the principal investigator. A second investigator accompanied the subjects for musculoskeletal ultrasonography who was blinded of the test results. The thickness of common extensor tendon, echo texture and lateral epicondyle bony contour was measured. The test results of the three provocative tests with ultrasonographic findings were analyzed. The sensitivity for Cozen’s test, Maudsley test and Mills test was found to be 84%, 88% and 53% respectively. The specificity for Cozen’s Maudsley and Mills test was found to be 0%, 0% and 100% respectively. Mills test showed significant area under receiver operator curve (ROC) i.e. (0.769), which explains that the test has good diagnostic accuracy. This validation study, concludes that Mills test has an excellent diagnostic value for ruling in LE.
KEYWORDS:Lateral epicondylitis, Tennis elbow, Provocative tests, Diagnostic accuracy.

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