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(9,10) Use X-rays first when: Trauma is present Pain is persistent or unclear Mechanical symptoms are reported (locking, catching) If X-rays are negative, further imaging should be based on clinical suspicion: Suspected fracture (occult) → Repeat X-ray (10–14 days) or CT Suspected tendon or ligament injury → Ultrasound or MRI Persistent epicondylopathy not improving with care → Ultrasound or MRI Mechanical symptoms (locking, catching) → MRI or CT (± arthrogram) Suspected nerve involvement → Ultrasound or MRI Clinical takeaway: Start with X-ray

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doi: 10.1007/s00775-009-0600-y