Elbow Arthritis

Question 1

What are the causes of elbow arthritis?

Answer 1

1. RA (MC)
2. Gout
3. Trauma
4. OA (not as common)
5. Septic bursitis

Question 2

What are some of the symptoms from the different causes?

Answer 2

1. RA: pain, swelling, instability as it advances
2. Non-RA inflammatory: pain, swelling, effusion, loss of motion, warmth
3. Post-traumatic: pain and/or stiffness
4. Septic: acute and severe pain, stiffness, warmth, swelling, effusion, fever, chills, malaise

Question 3

What will be found on the PE?

Answer 3

1. RA: swelling, RA nodules, tenderness, decreased ROM, varus/valgus instability
2. OA/trauma: motion loss from osteophytes, tenderness at joint line, crepitus
3. Non-RA inflammatory/sepsis: very painful ROM, decreased ROM, effusion, warmth

Question 4

What are the tests to conduct?

Answer 4

1. AP/lateral radiographs
   *osteopenia (RA)
   *joint narrowing (OA)
   *erosions
   *malunion/nonunion
   *osteophytes
2. MRI

Question 5

What are the treatment options? (RA)

Answer 5

1. Lifestyle modifications
2. RA management
3. CI
4. PT
5. Braces
6. Surgery (synovectomy, radial head excision, or total elbow arthroplasty)

Question 6

What are the treatment options (Non-RA inflammatory)

Answer 6

1. Treat the underlying cause
2. Aspiration and CI

Question 7

What are the treatment options (OA/trauma)

Answer 7

1. Analgesics and PT
2. Arthroscopy (osteophytes debridement, chondroplasty, loose body removal)
3. Joint replacement

Question 8

What are the treatment options (Septic)

Answer 8

1. OR ASAP