Elbow Diagnosis & Presentation

Question 1

Elbow instability subluxation & dislocation presents with?

Answer 1

FOOSH

may have: deformity, neural involvement, vascular involvement

Question 2

Elbow instability fractures present with?

Answer 2

fat pad/effusion
inability to fully extend elbow
history of trauma

Question 3

Common fracture of the elbow?

Answer 3

medial/lateral epicondyle
olecranon
radial head
coronoid process

Question 4

Complications from fractures?

Answer 4

loss of extension
mild to moderate pain
popping/locking suggest loose body
ulnar neuritis
Heterotrophic ossificans
Complex regional pain syndrome

Question 5

Heterotrophic ossificans present with?

Answer 5

pain with progressing loss of ROM

hyperemia, swelling, need for DD of septic arthritis, thrombophlebitis

may show increase serum alkaline phosphatase sedimentation rate and white blood count

xray may not show HO until 5th wk

Question 6

Posterolateral rotatory instability presents with?

Answer 6

vague elbow pain
lateral elbow pain
clicking, clunking, with supination
pt. reports of something wrong with extention/supination, elbow giving out with loading flexed elbow into supination

Question 7

Posterolateral rotatory instability MOI?

Answer 7

axial compression
valgus stress
supination, rotation at humeroulnar joint

Question 8

Valgus instability presents with?

Answer 8

medial elbow pain
pop felt at time of injury
tender UCL

Question 9

Valgus instability MOI

Answer 9

acute FOOSH or insidious overuse excessive valgus

Question 10

Lateral tendinitis/osis presents with

Answer 10

point tenderness distal to humerus
difficulty gripping
pain with wrist flexion & active wrist extension
more common in: 30-50 yo, women>men increase level of work

Question 11

Medial tendinitis/osis presents with

Answer 11

primary: prontator teres, FCR, palmaris longus
secondary: FCU, Flexor sublimis
male=female, 75 % dominant arm

Question 12

Biceps tendon rupture presents with

Answer 12

pop at injury
acute weakness
deformity present

Question 13

Bicepts tendon rupture MOI

Answer 13

rapid eccentric load with elbow supinated

Question 14

Ulnar nerve- cubital tunnel syndrome

Answer 14

2nd most common nerve entrapment in UE
parasthesia along ulnar distribution
clumsiness/loss of coordination of hand
popping/snapping during active flexion/extension

Question 15

Median nerve- pronator syndrome

Answer 15

anterior elbow pain
pain volar proximal forearm
sensing loss @ palmar surface of 2,3, quarter of 4
positive compression @ pronator border

Question 16

Median nerve- anterior interosseous syndrome

Answer 16

pain volar proximal forearm
no sensory loss @ fingers, motor weakness: FPL, FDP, thenar sparing
negative compression @ pronator border
inability to make ok sign

Question 17

Radial nerve- radial tunnel syndrome

Answer 17

deep ache distal to lateral epicondyle
pain at belly of brachioradialis
pain with resisted supination, repetitive wrist flexion/pronation
no motor/sensory loss

Question 18

RAdial nerve-posterior interosseous syndrome

Answer 18

lateral forearm/elbow pain
weak wrist extension & radial deviation (loss of ECU)
loss of ED, EDM, weak extensors of finger
motor loss only, thumb extension produces pain @ lateral epicondyle

Question 19

Osteoarthritis

Answer 19

males>female, 40-60yo
hx of repetitive use of UE in weight bearing occupation
loss of terminal extension, painful locking, pain @ end of flexion/extension
ulnawr neuropathy in 26-55% of pt. who go into surgery

Question 20

Forearm compartment syndrome

Answer 20

increase forearm pressure due to exertional activity
chronic, gradual onset
weakness, numbness, pain that doesn’t subside

Question 21

Olecranon bursitis

Answer 21

acute onset, unexplained swelling
septic, slightly more in males
hx of recent abrasion, repetitive trauma, hx of diabetes