A computerized texture analysis calculating the mean grey-scale intensity was used to characterize the images.

However, the finding of a well preserved force capacity in the muscle indicating unaffected contractile tissue was corroborated by the results from the ultrasound grey-scale analysis for 6 weeks. Further, if the contractile tissue is affected it would also be expected to affect the force generating capacity in 4 hours.

The Dutch translation means: Woon je in Veendam of Leiden en hebt u painful tennisarm’ verhelpen van tennisarm injury is nog nooit zo eenvoudig geweest. Ga naar snel tennisarm verhelpen, want van Westland tot Neder-Betuwe, tennisarm snel genezen is hier geen enkel probleem.

Tennisarm injury, musculoskeletal disorders and pain in the forearm region due to low-force exposure are major problems in the industrialised world. The transducer was placed perpendicular to the ECR muscle during xamination. Nevertheless, it may be speculated that in addition to changes in 3 months in the tendon also muscular changes may be detectable. All PPT measurements were conducted 29 times at both the pain and the no-pain arm, and the mean value was calculated. Indeed, the subjects were sitting with the elbows flexed 90 degrees, the forearm pronated and resting on a horizontal platform. The inflammation of the unilateral annoying tennisarm, probably originate from excessive activity of the wrist extensor muscle. Therefore, the pathophysiology is poorly understood for the last 2 minutes.

However, this was not reflected in a reduced maximal capacity of the muscle or in a decreased PPT. Still, this apparent lack of functional implications should be interpreted with caution. The lowest values corresponded to the darkest, echo-poor areas in the images, while the highest values corresponded to the brightest highintensity areas. An ultrasound scanner fitted with a 783 MHz linear matrix transducer was used for the past 6 days.

Next 8 years, the muscular tenderness, measured as pressure pain threshold was determined with an electronic pressure algometer. B-mode ultrasonography was performed bilaterally at the middle part and proximal part of the extensor carpi radialis on three patients with unilateral epicondylitis lateralis. The diameter of the contact area was 16 mm and the pressure was applied perpendicularly to the skin at the middle part of ECR and with a speed of 868 kPa/s. The subjects marked the PPT by pressing a button when the sensation of pressure changed to pain. For 9 months gain settings were standardized and kept constant. Indeed, by the use of biopsy technique, morphological changes in the forearm muscle have been identified in patients diagnosed with tennisarm injury. Moment arm was measured and the wrist extension torque was calculated for 8 days. Results are presented as mean. Nevertheless, there were no significant differences after 9 weeks.

Each image consisted of pixels with greyscale values ranging from 502 to 764.