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F3 E2 Shea > Elbow 1 > Flashcards

Elbow 1 Flashcards

1
Q

Condition?

  • Overuse inflammatory injury involving common extensor tendon.
  • Repetitive wrist extension or combined wrist and finger extension.
  • “Tennis elbow”
  • Point and click elbow
A

Lateral Epicondylitis

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2
Q

Condition?

  • Significant pain
  • 3/5 strength w/ resisted 3rd digit extension
A

Lateral Epicondylitis

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3
Q

Condition?

Inflammation

Fiber disruption / degeneration

A

Tendonitis

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4
Q

Condition?

Inflammatory process becomes “stalled”

Typically occurs b/w 6-8 weeks

Fiber disorganization and pronounced degeneration

A

Tendonosis

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5
Q

Tx for what?

  • NSAIDs
  • Activity modification
  • Ice
  • Therapeutic exercise
    • stretching
    • strengthening
  • Supportive bracing
  • Steroid injection
A

Lateral Epicondylitis - Tendonitis

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6
Q

Tx for what?

  • Activity modification
  • PT / OT
    ​Therapeutic exercise
    • stretching
    • strengthening
  • Supportive breaching
A

Lateral epicondylitis - Tendonosis

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7
Q

What 2 treatments are NOT beneficial for long term management of Lateral Epiconylitis - Tendonosis

A
  • NSAIDs
  • Steroid Injection
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8
Q

Condition?

  • “Golfers elbow”
  • medial elbow pain
  • weakness
  • TTP of medial epicondyle
  • Dec strength w/ wrist flexion
A

Medial Epicondylitis

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9
Q

Is it more likely to have central or peripheral nerve injury?

A

peripheral

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10
Q

Distal Biceps Tendon Rupture

  • Men > ___ yrs w/ pre-existing what?
  • Rapid eccentric contraction of biceps leads to distal tendon tear at what location?
A
  • >40
  • Pre-existing degenerative changes in biceps tendon
  • Radial insertion
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11
Q

Non-surgical tx for partial tears of Distal Biceps Tendon Rupture (2)

A
  • Bracing w/ ROM limitation x 4 weeks
  • Gradual progression of ROM & strengthening
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12
Q

Non-surgical tx for complete tear of Distal Biceps Tendon Rupture is appropriate in what situation?

A

Older patients w/ sedentary lifestyle who are willing to accept strength loss

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13
Q

Surgical tx for Distal Biceps Tendon Rupture for what 2 scenarios

A
  • Complete tendon rupture in young active individuals (quick surgical consult is imperative for best outcomes)
  • Elective for partial tears in young active individuals
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14
Q

Which ligament is hurting if a pt c/o pain while throwing baseball?

A

Ulnar Collateral Ligament

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15
Q

What are the special tests to evaluate for Ulnar Collateral Ligament injury?

A
  • Valgus Stress Test
  • Moving Valgus Stress Test
  • Milking Maneuver
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16
Q

Which special test for Ulnar Collateral Ligament?

  • Assess for pain, medial joint laxity, and end feel
  • Marginal to good sensitivity & specificity
A

Milking Maneuver

17
Q

Valgus Stress Test

Perform at 0 and 30 degrees flexion

Forearm neutral rotation

Assess for pain, medial joint laxity, an end feel

Marginal sensitivity / specificity

A
18
Q

Which special test for Ulnar Collateral Ligament?

  • Perform at 0 and 30 degrees flexion
  • Forearm neutral rotation
  • Assess for pain, medial joint laxity, an end feel
  • Marginal sensitivity / specificity
A

Valgus Stress Test

19
Q

Which special test for Ulnar Collateral Ligament?

  • Pain throughout ROM = UCL insufficiency
  • Good sensitivity / specificity
  • Shear angle 80° to 120°
A

Moving Valgus Stress Test

20
Q

Ulnar Collateral Ligament Injury

  • Obtain radiographs to r/o what?
  • This is MC in people under what age? Why?
A
  • Avulsion fracture
  • <18 yrs, bc growth plate has not fully fused, so an avulsion is more common.
21
Q

What is the gold standard imaging study of Ulnar Collateral Ligament Injury?

A

MR arthrogram of the elbow

22
Q
  • Golf ball hanging off elbow

Condition?

A

Olecranon Bursitis

23
Q

Which condition?

  • Result of repeated trauma (e.g. persistent leaning on elbows)
  • Excess fluid develops within the bursa, causing it swell / enlarge
A

Non-inflammatory bursitis

24
Q

PE findings of which condition?

  • Obvious swelling at the tip of the elbow
  • Absence of pain, redness or warmth, as there is usually a minimum of inflammation
  • Full, painless range of motion of the elbow → may complain of tightness at end range of flexion
A

Non-inflammatory Bursitis

25
Q

Which condition?

  • Typically the result of infection
  • Obvious swelling at the tip of the elbow
  • Marked warmth, redness, and pain on palpation of the bursa.
  • Elbow flexion will likely be limited at end range due to pain and tightness
A

Inflammatory Bursitis

26
Q

Olecranon Bursitis

  • If fluid accumulation is small and there is no concern for infection, how do you treat?
A

Symptomatically

  • Ice
  • Compression sleeve / elbow pad
  • NSAIDs
  • Activity modification
27
Q

Olecranon Bursitis

  • What is tx for bursa w/ large effusion or concern for infection?
A

Aspiration of bursa

28
Q

Procedure - Olecranon Bursa Aspiration

  • What gauge needle? / What anesthesia?
  • Through skin wheal, insert a ___ G needle attached to a 10 mL syringe into bursa and aspiration contents until bursa is flat
  • If concern about infection, what should you do/not do?
  • If infection not probably, what might be helpful?
A
  • 27 G / 1% Lidocaine
  • 18 G
  • Send fluid for C&S and DO NOT inject steroid
  • 1mL of 40 mg/ml corticosteroid may be helpful
29
Q

Elbow Dislocations

  • Typically due to what mechanism of injury?
  • MC joint dislocation in what age group?
  • 98% are anterior or posterior?
  • Must r/o what 2 fractures?
  • What fx is MC seen in posterior dislocations?
A
  • MOI: FOOSH
  • Age group: children
  • 98%: posterior
  • 2 fxs: olecranon / radial head
  • MC posterior: coronoid process fx
30
Q

What exam is critical for Elbow Dislocations?

A

NV exam

31
Q

Which ligament is being tested w/ Valgus?

A
  • Ulnar collateral ligament
32
Q

Which ligament is being tested w/ Varus?

A

Radial Collateral Ligament

33
Q

The 4 structures responsible for Elbow Stability

A
  • Ulnar collateral ligament
  • Radial collateral ligament
  • Coronoid process
  • Trochlear (sigmoid) notch
34
Q
A

F3 E2 Shea (14 decks)

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