MRI shows elbow joint effusion -- Tennis Elbow

[branimal1]

I've been suffering from tennis elbow for 10 months.  I've done / am still doing PT, ICE, Tens, Heat, voltaren gel and I still have no long term relief.  I have had one cortisone short 9 months ago and it worked for a short period of time.

Here are the findings of the MRI (actual summary attached)

1. Moderate sized left elbow joint effusion. Effusion is swelling within a joint.

2. There is a 12mm sized area of edema involving the common extensor tendon, compatible with lateral epicondylitis.  Edema is swelling that occurs outside a joint.

My options are to
1. get another cortisone shot (its been 9 months)
2. get tennis elbow surgery (80% success rate, min 3 months recovery)
3. Continue doing PT / rest

Any other options?

I'm leaning toward getting another cortisone shot (its been 9mo).  Can the orthopedic surgeon pinpoint the edema and neutralize it with cortisone?  How long do I need to rest for before I can go back to full blown exercise?

What do you guys think?