Patient case (clinical description): A 17-year-old male comes to the office due to several months of right elbow pain.  The pain is worse with activity and limits his workouts and activities.  He has tried over-the-counter medications with limited relief.  Medical history is notable for eczema, and current medications include a topical hydrocortisone ointment.  He is sexually active with his girlfriend and uses condoms. He does not smoke or drink alcohol. He plays tennis most of the days of the week. The comprehensive evaluation shows pain on the lateral side of the elbow, made worse by pressure applied on the lateral epicondyle of the humerus and when making a fist with the elbow joint straightened. The patient has this pain since last year and had several courses of physical therapy.

Patient's own account: I'm 17, and I had to go to the doctor because I've been suffering from my right elbow for several months. The pain is even worse when I do sports and it kind of limits me for my workouts and activities. I tried over-the-counter medications but it didn't work much. I had eczema before and my medication is ointments that contain cortisone. I am sexually active as a 17-year-old guy, and I have a girlfriend, and we use condoms. I don't smoke or drink. I play tennis most days of the week. I did an exam that showed pain on the side of my elbow and it was worse when they applied some pressure on it and when I was putting my hand as a fist. I have had this pain since last year, and I had several sessions of physical therapy already.

Clinical trial: Dysport® Injection in the Treatment of Chronic Lateral Epicondylitis

Eligibility criteria:
Inclusion Criteria:

          -  Pain: pain will be assessed as the physician touches lateral epicondyle or passively
             flexing the patient's wrist and while the patient extends his/her wrist or 3rd finger
             against resistance. Individuals who fulfill two or more of above will be considered to
             have lateral epicondylitis.

          -  Symptom duration: should be at least 6 months.

          -  Previous trial of complete course of physiotherapy and corticosteroid injection.

        Exclusion Criteria:

          -  Rheumatoid arthritis

          -  Generalized polyarthritis

          -  Local elbow arthritis

          -  Simultaneous medial epicondylalgia

          -  Bilateral lateral epicondylitis

          -  Neurologic deficits (abnormal light touch sensation, deep tendon reflexes abnormality,
             radicular pain, radial nerve entrapment, signs of nerve root compression, decreased
             muscle force, multiple sclerosis, seizures)

          -  The use of corticosteroid in last 30 days

          -  Simultaneous use of drugs other than acetaminophen or physical therapy in the course
             of study

          -  Pregnancy

          -  Breast-feeding

          -  Previous hand surgery

          -  Having a hobby or job that needs finger extension
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 18 Years old.
Subject must be at most 80 Years

Eligibility (NLI label): Entailment