Anatomical Association Between Wrist Extensor Musculature and Topographical Pain Sensitivity Maps of the Elbow Area

• Published in: Journal of manipulative and physiological therapeutics 2012-06, Vol.35 (5), p.402-406
• Main Authors: Prados-Frutos, Juan Carlos, MD, PhD, Ruiz-Ruiz, Beatriz, PT, PhD, De-la-Llave-Rincón, Ana Isabel, PT, PhD, Arendt-Nielsen, Lars, PhD, Madeleine, Pascal, DSc, PhD, Fernández-de-las-Peñas, César, PT, PhD
• Format: Article
• Language: English
• Subjects: Cadaver; Dissection; Elbow; Elbow Joint - anatomy & histology; Elbow Joint - innervation; Humans; Male; Muscle, Skeletal - innervation; Muscle, Skeletal - physiology; Nociceptive Pain - physiopathology; Pain; Pain Measurement; Pain Threshold; Physical Medicine and Rehabilitation; Radial Nerve; Radial Nerve - anatomy & histology; Radial Nerve - physiology; Sensitivity and Specificity; Tennis Elbow - physiopathology; Wrist Joint - anatomy & histology; Wrist Joint - innervation
• ISSN: 0161-4754; 1532-6586
• DOI: 10.1016/j.jmpt.2012.04.005

Abstract Objective High-density topographical sensitivity maps have been developed to visualize nonuniformity deep tissue pain sensitivity in, for example, lateral epicondylitis (LE). The aim of this cadaveric study was to determine the anatomical association between the topographical sensitivity maps over the elbow area and wrist extensor musculature. Methods A topographical pressure sensitivity map consisting of 12 points forming a 3 × 4 matrix: 4 points in the superior part, 4 points in the middle, and 4 points in the lower part around the lateral epicondyle was marker on a 50-year embalmed cadaver. Color marker pins were inserted into each point. Pins were removed during the process of dissection, but the small holes created by their removal assured accurate relocation. Results Progressive dissection revealed that points 1 to 4 (superior line) were placed over the musculotendinous junction and belly of the extensor carpi radialis brevis (ECRB) muscle, points 6 to 8 (middle line) were placed over the musculotendinous junction and belly of the extensor digitorum communis muscle, and points 9 to 12 (inferior line) were located over the musculotendinous junction and belly of the extensor carpi ulnaris muscle. It was also observed that the superficial branch of the radial nerve runs between the belly of the ECRB and extensor digitorum communis muscles. Conclusions This study confirmed that anatomical location previously assumed supporting the important wrist extensor muscles, particularly the ECRB, in patients with LE as depicted by pressure pain sensitivity maps. This study also suggests a potential role of the superficial branch of the radial nerve in LE.