TAME & Musculoskeletal Embolization
Golfer's Elbow / Medial Epicondylitis Treated with TAME — Case Report
Author: Bow Wang, M.D.
Ms. L, 54 years old, enjoys embroidery and runs her own orchard. For the past six months, she has frequently experienced pain on the inner side of her right elbow joint. After examination, she was diagnosed with medial epicondylitis, commonly known as golfer's elbow.
Ms. L has tried painkillers, patches, and local injections including steroids and high-concentration glucose solutions. She has also undergone rehabilitation treatments, but the pain persists,
and her pain index reaches 8-9 out of 10. She was referred by Dr. Ko Po-Yen, an orthopedic surgeon at National Cheng Kung University Hospital,
to the Interventional Clinic (Bow Wang, M.D.) for further evaluation and interventional treatment. Based on imaging assessments including magnetic resonance imaging (MRI), the patient was diagnosed with a medial elbow tendon injury. After discussion with Ms. L, it was decided to proceed with treatment using Transarterial Microembolization (TAME).
During the Bow Wang, M.D. treatment, Ms. L marked the painful area with a metal plate. Angiography revealed corresponding enlarged capillary-like vessels at the painful site, which were then embolized and removed.
Two weeks after treatment, Ms. L's medial elbow pain index decreased from 8-9 points to 4 points, and the swelling significantly improved.
Golfer's elbow, medically known as medial epicondylitis, is caused by the medial epicondyle, the bony prominence on the medial side of the distal humerus. The medial epicondyle is the attachment point of the muscles involved in wrist flexion (bending towards the palm). It's a common sports injury in golf, hence the name. Anyone who requires prolonged, repetitive use of the forearm and wrist is at high risk. This includes baseball players, bowlers, chefs, computer and clerical workers, housewives, hairdressers, and workers who perform specific, repetitive wrist movements for extended periods. Overuse of the wrist or sprains causing localized injury can lead to localized pain on the inner side of the elbow. This muscle pain can further weaken the wrist and impair its function.
Bow Wang, M.D. reminds you that the application of 【Transarterial Microembolization (TAME)】 in treating "medial epicondylitis of the humerus" has its limitations. The main indication is a pain index exceeding 5 points, and patients who have not shown significant improvement after more than three months of various treatments.
This treatment is not suitable in the following situations:
1. Severe tendon or ligament damage or rupture
2. Pain accompanied by other nerve compression symptoms, such as numbness
3. Poor kidney function (eGFR < 30 mL/min/1.73m2)
4. Low platelet count, abnormal coagulation function
5. The patient is unable to lie flat for two hours
6. Pregnancy
Side effects of the treatment include local hematoma and bruising at the puncture site; and temporary local discoloration at the embolization site, which will improve and disappear within minutes to a month.
Bow Wang, M.D. points out that treatment with 【Transarterial Microembolization (TAME)】 requires evaluation by a professional physician before implementation. Its main effect is pain relief. Regular attention should be paid to the maintenance of joints and tendons, and adequate rest is essential. Taking care of your joints and tendons is far more effective than treating excessive strain!
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This page is for medical education and academic communication. It does not replace individual diagnosis or treatment advice.
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