Elbow Flashcards
Froment’s sign
What is it?
How is it conducted?
What is the positive sign?
- test for ulnar nerve palsy - paralysis of adductor pollicis
- pateint grap piece of paper between thumb & index finger on both hands > paper pulled away
- patient unable to adduct thumb > instead flex thumb
Musculocutaneous nerve injury
What causes it?
What are the symptoms?
- stabbing at axilla, anterior dislocation of humerus,
- x motor function of anterior arm muscles, loss of sensation over lat. side of forearm
Supracondylar fracture of distal humerus
What causes it?
What age group is common?
How would the xray be like?
What are the 3 main complication?
- falling onto outstretched hand with elbow hyperextended
- 5-7 yrs
- distal fragment displaced posteriorly
- Cubitus varus due to malunion. Damage to median, radial or ulnar nerve. Volkmann’s ischaemic contracture
Volkmann’s ischaemic contracture
What is the pathophysiology like?
What is the presentation like?
- brachial artery damage > ischaemia of muscles in anterior forearm > oedema and compartment syndrome > infarction of muscles > fibrosis occurs > fibrotic tissue contracts > flexion contracture
- wrist flexed, fingers extended at MCPJ, flexed at IPJ, pronated forearm, flexed elbow
Dislocated elbow
What causes it?
What type of dislocation is more common?
- fall on outstreched hand with elbow partially flexed
- posterior (in reference of ulnar and radius)
Nursemaid’s elbow
What is the other term called?
What is it ?
Common in which age group?
What causes it?
What is the mechanism of injury?
- Pulled elbow
- subluxation of radial head
- 2-5 yrs
- longitudinal traction applied to arm with forearm pronated, overreaching for an object
- longitudinal traction of radial head > tears annular ligament > radial head displaced distally though torn ligament
Radial head and neck fractures
What causes it?
What are the symptoms?
What are the x ray signs?
- fall on outstretched hand when radial head impacts on capitellum of humerus
- pain in lateral aspect of proximal forearm, loss of range of movement
- Fat pad/sail sign - presence of effusion
OA of elbow
Men or women are more prone?
What are the symptoms?
- Men
- crepitus, locking in elbow, swelling, parasthesia & muscle weakness due to osteophytes impinge on ulnar nerve
RA of elbow
What are the x ray features?
What is the pathophysiology?
- joint space narrowing, periarticular osteopenia, marginal bony erosions, subluxation and gross deformity
- autoimmune disease > autoantibodies (rheumatoid factor) attack synovial membrane > synovial cells proliferate . pannus formed > pannus penetrates cartilage and adjacent bone > joint erosion & deformity
Tennis elbow
What is it?
What is the pathophysiology?
What are the symptoms?
What are the treatments?
- Lateral elbow tendinopathy - caused by chronic overuse disorders in tendons
- ECRB weakened from overuse > microscopic tear form in the tendon > inflammation and pain
- pain at lateral epicondyle during wrist extension
- modify activity, physiotherapy
Golfer’s elbow
What is it?
What does it affect?
Where is the commone site of pathology?
What are the symptoms?
- medial elbow tendinopathy
- common flexor origin at medial epicondyle
- interface between pronator teres and FCR origins
- pain at medial elbow
Student’s elbow
What is it?
What causes it?
What are the presentation of swelling?
What are the treatments?
What are the complication?
- olecranon bursitis
- repeated minor trauma - eg: leaning with elbows on desk for many hours
- soft, cystic, transilluminates
- compression bandaging, hydrocortisone injection
- infection of bursa
Rheumatoid nodules
What is it?
What are the risk factors?
Where does it occur?
What is the nodule like?
- extra-articular manifestation of RA
- smokers, aggresive joint disease
- regions subjected to repeated minor trauma (elbow, fingers, back of heel)
- non tender, overlying skin ulcerate, infected
Cubital tunnel syndrome
What is it?
What causes it?
What is the treatment?
- ulnar nerve compression between two heads of FCU and beneath tendinous arch
- minor trauma to ulnar nerve - eg; banging elbow on desk
- Surgical decompression of nerve
Gouty tophi
What is it?
Which patients are prone of getting?
What are the symptoms?
What are the complications?
Where does it commonly occur?
- nodular masses of monosodium urate crystals deposited in soft tissue
- untreated gout
- painless
- pain, soft tissue damage & deformity, joint destruction, nerve compression
- fingers, ears, olecranon bursa, subcutaneous tissue of elbow
