Radiographic analysis of elbow carrying angle and its association with pain severity, grip strength, and manual dexterity among participants with lateral elbow tendinopathy: A cross-sectional study

Lateral epicondylitis, or tennis elbow, is a tendinopathy of the common extensor origin, most frequently involving the extensor carpi radialis brevis, and is characterized by pain and tenderness over the lateral epicondyle, especially during gripping and resisted wrist extension. Repetitive wrist extension and forearm supination, forceful gripping, and sustained or awkward upper limb postures are recognized mechanical contributors, but the condition reflects a multifactorial process involving mechanical strain, microtrauma, and individual anatomical predispositions. The prevalence of lateral elbow tendinopathy in the general population is estimated at 1 to 3 percent, with peak incidence in adults between 30 and 60 years. Prospective studies and meta analyses confirm that biomechanical exposure at work significantly raises the incidence of lateral elbow tendinopathy. The carrying angle is formed between the humerus and ulna in the extension position of the elbow. It is an anatomical factor that may influence tendon loading. Radiographic studies have reported that higher carrying angles in individuals with lateral elbow tendinopathy, suggesting that altered valgus alignment may increase tensile stress on the extensor carpi radialis brevis origin during gripping activities. Functional impairment in lateral elbow tendinopathy is commonly quantified through objective grip strength testing using a handheld dynamometer, and patient reported outcomes such as the Patient Rated Tennis Elbow Evaluation. Together, these tools capture both mechanical deficits and perceived disability. The study aims to examine the association between elbow carrying angle and pain severity, grip strength, and manual dexterity in individuals with lateral elbow tendinopathy. The findings may help improve understanding of biomechanical factors influencing pain and functional limitations in the upper limb.