Case 1

Patient basic data: Michael M., male, dob 01.01.1979 (41y/o), non-smoking, no treated hypertension, or diabetes.

Symptom: Pain in the right lateral elbow region

Fictional diagnosis: Lateral epicondylitis of the humerus (tennis elbow)

History: The patient has a normal desk job, but has been doing leisure sports for years. For 10 months now he no longer participates in his previous sport that primarily involved running and instead has started playing badminton with friends twice a week. During this time he has noticed pain in the right (dominant arm) lateral elbow and the nearby forearm muscles, especially in the days after training. This pain is intensified by activities with a firm grip (e.g. opening screw caps, carrying water boxes, etc). These specific complaints have never completely resided and instead have increased in the last few weeks, reaching a 5 of “moderate pain” intensity on a visual analogue scale (VAS), ranging from 1 no pain to 10 worst pain. The patient does not recall any past trauma to this region, and does not have any other complaints in other parts of the body. He has not yet seen a doctor for this reason, but because of the pain, which is now considered to be unpleasant, one day after a game he uses the AI app.

Examination results: Pressure pain above the lateral epicondyle of the humerus and pressure pain in the proximal muscles of the forearm with tender muscles. No signs of inflammation such as redness, swelling/articular effusion, overheating, or any lasting disturbance of function in everyday life. Range of motion (ROM) is not restricted, peripheral circulation, motor function and sensitivity are intact.

Not anticipated while creating the vignette (and filled in while using the app in this trial): No lumps under the skin on the elbow, no lumps under the skin on the forearm or hand, no muscle cramps in the arms and hands, no bruise on the arm, no reduced mobility of the fingers, no reduced mobility of the wrist.

Number of symptom-related questions: 27

General app estimation (“next steps”): People with symptoms similar to yours can usually manage their symptoms safely at home. You could also seek advice by visiting or contacting your local pharmacy. If your symptoms persist longer than expected, if they get worse, or if you notice new symptoms, you should consult a doctor for further assessment and advice.

Suggested diagnoses: 1. Tennis elbow (can usually be managed at home): 7 out of 10 people with these symptoms had this condition (➔ suggested therapy: Cryotherapy, medication against pain and inflammation, and physical therapy) 2. Golfer’s elbow (can usually be managed at home): 2 out of 100 people with these symptoms had this condition. 3. Less likely causes: Injury due to chronic overuse of the forearm muscles (1 out of 1000 people with these symptoms had this condition).

Note: no questions were asked about the specific side of the affected elbow (i.e. medial vs. lateral); it was not asked whether the complaints would also become stronger at rest or more so during activity (stated pain: moderate; theoretically: hardly at rest, stronger under stress).