New Insights on Feline Golfer’s Elbow: Diagnosis & Treatment Outcomes in 9 Cats

Medial humeral epicondylitis: a retrospective case series of nine cats (17 elbows)

Mary Baldeon, Karen Lisette Perry

Background
Medial humeral epicondylitis (MHE) is a degenerative condition affecting the flexor carpi ulnaris muscle (FCUM) in cats, comparable to “golfer’s elbow” in humans. It is characterized by tendon degeneration, mineralization, and often ulnar nerve involvement. Previous feline reports relied primarily on radiography for diagnosis, typically identifying disease only in advanced stages. This study aimed to expand clinical knowledge of MHE by describing presentation, diagnostic findings, and response to non-surgical and surgical treatments in nine cats (17 elbows).

Methods
A retrospective review (2015–2025) at Michigan State University Veterinary Medical Center included cats with radiographically confirmed unilateral or bilateral MHE. All cases received non-surgical management before considering surgery, with at least 6 weeks of follow-up. Data included signalment, orthopedic exam findings, radiographic/CT/ultrasound results, treatments, and outcomes. Radiographs graded severity (mild, moderate, severe) and identified mineralization zones. Surgical cases underwent open removal of mineralized tissue, neurolysis for ulnar neuritis, and FCUM tendon reattachment, followed by carpal flexion bandaging or orthotic support.

Results
Median age was 6 years (range 1–15); eight cats had bilateral disease. Common clinical signs were pain over the medial epicondyle (15/17 elbows), pain on elbow pronation/supination (7/17), pain on carpal flexion (7/17), and palpable mineralization distal to the medial epicondyle (7/17). Radiographic grading: mild (8 elbows), moderate (7), severe (2). CT (10 elbows) revealed additional findings in 7 cases, notably intra-articular mineralized bodies. Ultrasound (4 elbows) identified fluid around FCUM tendons and pinpoint mineralization.
Non-surgical treatment yielded complete resolution in 1 cat, partial improvement in 4, and no improvement in 4; milder radiographic disease was more responsive. Surgery was performed on 4 cats (7 elbows); ulnar neuritis was present in all. At 8–9 weeks post-surgery, lameness resolved in 3 cats (5 elbows) and improved in 1 cat with concurrent osteoarthritis. Long-term follow-up (13–72 months) in 3 cats showed no recurrence in 2 and stable mild lameness in 1.

Limitations
Small sample size and retrospective design limit generalizability. Follow-up duration and completeness varied, and diagnostic imaging modalities were inconsistently applied before radiography. Possible breed predisposition was observed but not statistically analyzed.

Conclusions
MHE in cats often presents with insidious, moderate lameness and pain localized to the medial epicondyle, sometimes with palpable mineralization. Ulnar neuritis is common, and intra-articular mineralized bodies may be present. Radiographs detect only advanced disease, limiting early treatment success with non-surgical management. CT can reveal additional lesions, and ultrasound may allow earlier diagnosis. Surgical management yields favorable outcomes, particularly when performed before severe degenerative changes occur.

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