Common Extensor tendinopathy is one of the most common overuse injury of elbow. With the repetitive overload and microtrauma of elbow it may eventually leads to tear of the common extensor tendon that is rare.

In this case report we describe a case of a middle aged man pilot by profession presented with chief complaints of pain in elbow and a clinical history corresponding with tendinopathy caused by repetitive overload of common extensor tendon due to repeated use of his hand and elbow as per according to his job demand. On examination tenderness was present around lateral aspect of elbow with painful range of movements and weak and painful grip. Initial diagnosis was made clinically for lateral epicondylitis and ultrasound imaging was done to correlate with the clinical findings which showed a frank 4mm tear of i.e. hypoechoic swelling of tendon with focal interruption of internal fibrillar pattern and soft tissue indentation unlike microtear of tennis elbow. Clinical diagnosis of common extensor tendon rupture was confirmed in this patient who had clinical history corresponding to lateral epicondylitis.

Patient was treated with injection PRP(Platelet Rich Plasma) given in weekly intervals under ultrasound guidance and in follow up it showed decrease in size of tear and healing of tear of common extensor tendon.

This case report is to highlight upon a fact that PRP can be a promising treatment for tendon tears which have shown good result in this case report.

1. Morrey B. Anatomy of the elbow joint. In: Morrey B, ed. The elbow and its disorders. Philadelphia, PA: Saunders, 1993:16–52].
2. Hume P.A., Reid D., Edwards T. Epicondylar injury in sport: epidemiology, type, assessment, management and prevention. Sport Med. 2006;36(2):151-170. [PubMed]
3. AG Smith, K K Kosygan, H Williams, R Newman. British Journal Of Sports Medicine.1999;33:423-425
4. Martinoli C., Bianchi S., Giovagnorio F., Pugliese F. Ultrasound of the elbow. Skelet Radiol.2001;30:605-614
5. Schwarz A. A Promising Treatment for Athletes, in Blood. The New York Times;2009.
6. David M. Dohan Ehrenfest, Lars Rasmusson, Tomas Albrektsson Department of Biomaterials, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Sweden volume 27, Issue 3, March 2009, Pages 158-67]
7. Mehta V. Platelet-Rich Plasma: A Review of Science and Possible Clinical Applica-tions. ORTHOPEDICS. 2010; 33(2)
8. Andia I, Abate M: Platelet rich plasma: underlying biology and clinical corelates. Regen Med 2013;8;645-658].
9. Weibrich G, Kleis WK, Hafner G, Hitzler WE. Growth factor levels in platelet-rich plasma and correlations with donor age, sex, and platelet count. J Craniomaxillo-facial Surg 2002; 30:97–102]
10. Anitua E, Andia I, Sanchez M, Azofra J, del Mar Zalduendo M, de la Fuente M, Nurden P, Nurden A. Autologous preparation rich in growth factors promote proliferation and induce VEGF and HGF production by human tendon cells in culture. J Orthop Res.2005;23:281-286.
11. Schnabel LV, Mohammed HO, Miller BJ, McDermott WG, Jacobson MS, Santangelo KS, Fortier LA. Platelet rich plasma(PRP) enhances anabolic gene expression pattern in flexor digitorum superficialis tendon.J Orthop Res.2007; 25:230-240.
12. Kachrimanis, O Papadopoulos J ultrasound. 2010 Jun; 13(2): 74-75.
13. Levin D., Nazarian L.N., Miller T.T. Lateral epicondylitis of the elbow: US findings. Radiology. 2005;237(1):230-234]
14. Hume P.A., Reid D., Edwards T. Epicondylar injury in sport: epidemiology, type, assessment, management and preven-tion. Sport Med. 2006;36(2):151-170.
15. Martinoli C., Bianchi S., Giovagnorio F., Pugliese F. Ultrasound of the elbow. Skelet Radiol. 2001;30:605–614.
16. Draghi F., Danesino G.M., De Gautard R., Bianchi S. Ultrasound of the elbow. J Ultrasound. 2007;10:85–92.]
17. Everts PA, Knape JT, Weibrich G, et al. Platelet rich plasma and platelet gel: a review. J Extra Corpor Technol 2006; 38:174–187]
18. Thanasas C, Papadimitriou G, Charalambidis C, Paraskevopoulos I, Papanikolaou A. Platelet-rich plasma versus autologous whole blood for the treatment of chronic lateral elbow epicondylitis: a randomized controlled clinical trial. Am J Sports Med 2011; 39:2130–2134]
19. Everts PA, Knape JT, Weibrich G, et al. Plateletrich plasma and platelet gel: a review. J Extra Corpor Technol 2006; 38:174–187]
20. Thanasas C, Papadimitriou G, Charalambidis C, Paraskevopoulos I, Papanikolaou A. Platelet-rich plasma versus autologous whole blood for the treatment of chronic lateral elbow epicondylitis: a randomized controlled clinical trial. Am J Sports Med 2011; 39:2130–2134]

Dr Shikha Dhaundiyal

Postgraduate Resident, Department of Sports Medicine

VMMC and SJH