Occupational Endoscopy Hazard: Colonoscopistʼs (Tennis) Elbow and its Treatment
Bibliographic record
Abstract
Purpose: Lateral epicondylitis (tennis elbow) is an overuse injury which involves tendon inflammation or small ruptures at the attachment to the elbow. Repeated contraction of forearm muscles for at least two hours per day is associated with an increased risk of this condition. Performance of colonoscopy involves frequent use of forearm muscles when torquing the insertion tube which causes pain on wrist extension and difficulty lifting even light objects. Left untreated, tennis elbow can result in chronic pain. Current treatment options such as anti-inflammatory drugs, rest, elevation, ice or wraparound bandages are suboptimal choices for the busy endoscopist. We sought a simple treatment which would permit continued performnce of endoscopic procedures while at the same time lessen pain and promote tendon healing. Methods: In our endoscopy unit, 3 physicians, each with at least 10 years of endoscopy experience developed this painful condition. In two individuals the pain resolved spontaneously over 1-2 months. The third physician experienced persistent elbow pain as well as difficulty with wrist extension and lifting moderately heavy objects with his dominant right hand. To obtain pain relief, this physician tried a newly developed forearm brace that doesn't need to be extensively wrapped around the arm to be effective. Instead, users can adjust the amount of pressure on the inflamed tendon by turning a dial. Results: By using the new forearm brace, the physician reported major improvement in elbow pain while performing endoscopic procedures as well as during his usual activities at home. He was subsequently able to discontinue its use after 4 weeks of treatment. Conclusion: Endoscopists should consider lateral epicondylitis as an occupational hazard and seek early diagnosis and treatment to prevent a chronic pain syndrome. New orthotic braces are available which are easy to apply to relieve elbow pain and promote tendon healing.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.009 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".