Exams and Tests

Diagnosis is usually made based on the way the affected tendon and movement of the associated muscle feels. The doctor may have you do these movements to check for pain and tenderness:

• Medial epicondylitis: The forearm is placed in supine position, and the fist is flexed against resistance while the forearm is held down. Tenderness is felt in the area of the medial epicondyle and flexor pronator tendons.
  
  
• Lateral epicondylitis: The forearm is placed in prone position on the table, while the forearm is held in place. You try to extend your wrist against resistance. Tenderness is felt along extensor area.
  
  
• Rotator cuff tendinitis
  
  
  • Supraspinatus: Bend the arm to 90° and place it forward 30° with the thumb pointed down. Pain or weakness against resistance can be felt if there is involvement of this tendon.
    
    
  • Infraspinatus and teres minor: With your arm against your body with elbow bent at 90°, the doctor will stabilize the elbow against your waist and have you externally rotate against resistance, which will bring on pain if these tendons are involved.
    
    
  • Subscapularis: With your arm against your body and the elbow bent at 90°, while stabilizing the elbow, the doctor will have you internally rotate your arm inward around the front of your body against resistance, which will cause pain if this tendon is involved.
  
  
• Peripatellar tendinitis: Tenderness can be felt over the quadriceps tendon at the upper part of the kneecap.
  
  
• Popliteus tendinitis: Sit with the side of your injured heel resting on the knee of the opposite leg. Tenderness can be felt just in front of the fibular collateral ligament.
  
  
• Achilles tendinitis: Tenderness is felt when the Achilles tendon is squeezed between the fingers.
  
  
• Ultrasound evaluation of the tendon with real time machines can give an accurate diagnosis. A CT scan and MRI can be used. The MRI is better able to identify tears, partial tears, inflammation, or a tumor.