Elbow and Wrist Assessment

Question 1

Lateral Collateral Ligament - Special Tests (3)

Answer 1

Varus stress test
Chair push up test (posterolateral instability)
Gravity assisted varus stress

Question 2

Medial Collateral Ligament - Special Tests (2)

Answer 2

Valgus stress test
Moving valgus stress test

Question 3

Posterolateral Rotatory Instability - Special Test

Answer 3

Chair push up test

Question 4

Posteromedial Rotatory Instability - Special Test

Answer 4

Gravity assisted varus test

Question 5

Lateral Epicondyle Tendinopathy (Tennis Elbow) - Special Tests (3)

Answer 5

Cozen test
Maudsley’s test
Mills test

Question 6

Medial Epicondyle Tendinopathy (Golfer’s Elbow) - Special Test

Answer 6

Reverse cozen test

Question 7

Ulnar Nerve Entrapment - Special Tests (2)

Answer 7

Tinel’s sign
Elbow flexion test

Question 8

Carpal tunnel Syndrome - Special Tests (2+1)

Answer 8

Tinel’s sign
Phalen’s test
Flick sign

Question 9

Triangular Fibrocartilage Complex (TFCC) - Special Tests (2)

Answer 9

Load test
Chair press test

Question 10

De Quarvains - Special Test

Answer 10

Finkelstein test

Question 11

OA - Special Test

Answer 11

OA 1st carpometacarpal test

Question 12

Mill’s Test - Structure/Pathology, Positive signs, Sensitivity/Specificity

Answer 12

Lateral elbow tendinopathy (tennis elbow).
Pain reproduced on lateral side of elbow.
Specific (rule in).

Question 13

Cozen Test - Structure/Pathology, Positive signs, Sensitivity/Specificity

Answer 13

Common tendon of wrist extensors, lateral elbow tendinopathy (tennis elbow).
Reproduction of pain on lateral side of elbow.
Sensitive (rule out).

Question 14

Maudsley’s Test - Structure/Pathology, Positive signs.

Answer 14

Common tendon of wrist extensors, lateral elbow tendinopathy (tennis elbow).
Positive if pain is reproduced on lateral epicondyle.

Question 15

Reverse Cozen Test - Structure/Pathology, Positive signs, Sensitivity/Specificity

Answer 15

Common tendon of wrist flexors, medial elbow tendinopathy (golfer’s elbow).
Positive if pain is reproduced on medial side of elbow.
Sensitive (rule out).

Question 16

Tinel’s Sign at the Elbow - Structure/Pathology, Positive signs.

Answer 16

Ulnar nerve, entrapment, cubital tunnel syndrome.
Weakness, numbness, pins and needles along the ulnar nerve (medial side of palm and last 1,5 fingers).

Question 17

Elbow Flexion Test - Structure/Pathology, Positive signs.

Answer 17

Ulnar nerve, neuropathy, entrapment in cubital tunnel.
Pins, needles, numbness along ulnar nerve (medial side of palm, last 1,5 fingers).

Question 18

Valgus Stress Test - Structure/Pathology, Positive signs.

Answer 18

Medial collateral ligament (sprain, instability).
Reproduction of pain on medial epicondyle.

Question 19

Moving Valgus Stress Test - Structure/Pathology, Positive signs, Sensitivity/Specificity

Answer 19

Medial Collateral Ligament (sprain, instability).
Reproduction of pain at MCL and maximum pain between 120° and 70° (shear angle).
Sensitive (100%), Specific (75%).

Question 20

Varus Stress Test - Structure/Pathology, Positive signs.

Answer 20

Lateral Collateral Ligament, assessing integrity.
Pain on lateral side of elbow and excessive laxity compared to the other side.

Question 21

Gravity Assisted Varus Stress Test - Structure/Pathology, Positive signs.

Answer 21

Lateral collateral ligament, varus posteromedial rotatory instability.
Pain, grinding, feeling of instability during ROM in VPMI.

Question 22

Chair Push Up Test - Structure/Pathology, Positive signs, Sensitivity/Specificity

Answer 22

Lateral collateral ligament. Posterolateral rotary instability and ligament integrity.
Apprehension or visible dislocation of the head of the radius occurs during elbow extension.
100% sensitive (rule out), 75% specific (rule in).

Question 23

Tinel’s Signs at the Wrist - Structure/Pathology, Positive signs, Sensitivity/Specificity

Answer 23

Median nerve. Carpal tunnel syndrome.
Pins, needles, numbness, paresthesia are reproduced or increased along the median nerve (first 3,5 fingers and lateral side of palm).
Sensitive (rule out) and specific (rule in).

Question 24

Phalen Test - Structure/Pathology, Positive signs, Sensitivity/Specificity

Answer 24

Median nerve. Carpal tunnel syndrome.
Numbness, tingling, paresthesia along the median nerve, 1st 3,5 fingers and lateral side of hand.
Sensitivity (rule out) .92, specificity (rule in) .88.

Question 25

Load Test of Triangular Fibrocartilage Complex - Structure/Pathology, Positive signs.

Answer 25

TFCC injury.
Positive if patient has pain on ulnar side, and/or clicking during the manoeuvre.

Question 26

Chair Press Test - Structure/Pathology, Positive sign.

Answer 26

TFCC injury.
Positive if pain is evoked and/or clicks are present.

Question 27

Finkelstein Test - Structure/Pathology, Positive signs.

Answer 27

Tendons surrounding anatomical snuff box.
De Quervain’s tendinopathy (extensor pollicis brevis and abductor pollicis longus).
Pain over radial styloid area.

Question 28

Grind Test for 1st CMC - Structure/Pathology, Positive signs, Specificity/Sensitivity.

Answer 28

Trapeziometacarpal joint. OA of 1st carpometacarpal joint.
Pain or crepitation during test.
Specific (rule in).