{"text":"Department of Trauma & Orthopaedics \nGlasgow Royal Infirmary \n84 Castle Street \nGlasgow \nG4 0SF \nTelephone: 0141 211 1243 \nFax: - 0141 211 0481 : \u2018 \nAppointments: 0141 211 4608 \n\" MRLARYMASZEWSKI'S ELBOW CLINIC \nClinic and dictated: 21\/10\/2008 \nTyped: 23\/10\/2008 \nOur Reference: MS\/HB \nDr Marjory Stephens \nKilsyth Health Centre \nBurngreen Park c \nKilsyth \u2018 : \nStirlingshire : \nG650HU - \nDear Dr Stephens \nRe: Mrs Agnes Clelland 08\/09\/1955; CHI: 0803555328; CRN: 10338654X \n39 Rennie Road Kilsyth Glasgow Lanarkshire G65 3PQ \nDiagnosis; Exacerbation of right tennis elbow following fall \nOutcome; Commence physiotherapy at Kilsyth Health Centre \nSteroid and local anaesthetic injection of tennis elbow \nThis 63 year old lady who is right hand dominant gives a history of having tennis elbow for several years. She has \nhad anti inflammatory steroid injections in the past.- She reports having a mechanical fall where her right elbow was \ncompressed between a wall and her own body a few months ago. This seemed to have stirred things up. She \nunderwent a cortisone injection approximately six weeks-ago which was injected into her proximal forearm which \ndidn\u2019t seem to help her symptoms. She reports occasional pins and needles which are more recent and in the \nmedian nerve distribution\u2018suggestive of carpal tunnel syndrome. \nOn examination there is no-obvious swelling or deformity with tenderness over the lateral epicondyle. Full range of \nmovement - extension\/flexion as well as pronation\/supination. She is tender over the lateral epicondyle as well as \nthe extensor mobile wod. Resistance of wrist extension reproduces her symptoms. \nX-rays do not show any obvious bony deformity. Some calcification noted at the insertion of ECRB. | have injected \nher lateral epicondyle with 5m! of .5% Marcaine with Kenalog We have referred her for physiotherapy. She has \nbeen discharged from the clinic. \nYours sincerely, \nM Siddiqui \nSpecialist Registrar, ORTHOPAEDICS 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