[Golfer's Elbow/Medial Epicondylitis] [Traditional Type Combined with Simplified Type Transarterial Microembolization (TAME)] Successful Case Sharing

Mr. C, 44 years old, has been experiencing persistent pain on the inner side of his right elbow for the past three years. A doctor's examination diagnosed him with medial epicondylitis, commonly known as golfer's elbow.

Mr. C had tried painkillers, patches, and local injections including steroids, high-concentration glucose solutions, and PRP, as well as rehabilitation treatments, but the pain persisted for over three years, with a pain index as high as 8 out of 10. He was referred by Dr. Lin Weiping, Rehabilitation Specialist at Yu-Tung Clinic in Tainan City, to the Interventional Medical Center at National Cheng Kung University for further evaluation and interventional treatment using Bow Wang, M.D.. Based on imaging assessments including magnetic resonance imaging (MRI), the patient was diagnosed with a medial elbow tendon injury. After discussion with Mr. C, it was decided to proceed with the traditional Transarterial Microembolization (TAME) treatment.

Bow Wang, M.D., using both magnetic resonance angiography and conventional angiography, identified the enlarged capillary-like vessels corresponding to the pain area in Mr. C's medial elbow and performed embolization to remove these vessels.

Two weeks after conventional embolization treatment, Mr. C's medial elbow pain index decreased from 8 to 4, and the swelling significantly improved. Bow Wang, M.D. initially planned to continue with high-concentration glucose injections for Mr. C's enlarged vessels, but after discussion, Mr. C decided to undergo treatment guided by ultrasound and the simplified Transarterial Microembolization (TAME).

Two weeks after simplified embolization treatment, Mr. C's medial elbow pain index further decreased from 4 to 1.5. After two embolization treatments, the patient's pain score dropped significantly from 8 to 1.5, and range of motion and quality of life also improved markedly.

[Golf's elbow] is medically known as [Medial Epicondylitis]. The medial epicondyle is the bony prominence on the medial side of the distal humerus. It is the attachment point of the tendons and muscles involved in wrist flexion (bending towards the palm). This is a common sports injury in golf, hence the name. Anyone who requires prolonged, repetitive use of the forearm and wrist is at high risk, including 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 soreness on the inner side of the elbow. This muscle soreness can further cause wrist weakness and impaired function.

Bow Wang, M.D. reminds you that the application of 【Transarterial Microembolization (TAME)】 in treating 【medial epicondylitis of the humerus】has limitations. Its 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

Treatment side effects include possible local hematoma, bruising, and soreness at the puncture site; temporary local skin discoloration at the embolization site may occur, all of which will improve and disappear within one month.