Elbow Examination

Question 1

what are some things to observe in regards to the elbow?

Answer 1

Carrying angle
Normal 5°-10° males
Normal 10°-15° females
Triangle Sign→ screen for potential fracture
Olecranon Bursitis
Presence of edema, effusion, ecchymosis and/or erythema
Check tissue temp

Question 2

what are some muscular elbow pathology?

Answer 2

Lateral epicondylitis
Medial epicondylitis
Distal biceps rupture/strai

Question 3

what are some instability elbow pathology?

Answer 3

Medial instability → UCL
Lateral Instability

Question 4

what are some nerve compression elbow pathology?

Answer 4

PIN syndrome → radial
Cubital tunnel syndrome → ulnar
Pronator syndrome → median

Question 5

what are some fracture/ dislocation/ subluxation elbow pathology?

Answer 5

Supracondylar
Radial head
Intracondylar

Question 6

what are some other elbow pathologies?

Answer 6

Osteochondritis dissecans
Osteochondrosis
Myositis ossificans
Olecranon bursitis

Question 7

what is the first diagnosis if the patient present with pain over lateral elbow during gripping activities?

Answer 7

lateral epicondylitis

Question 8

what is the first diagnosis if a patient presents with pain over medial elbow with wrist flexion & pronation?

Answer 8

medial epicondylitis

Question 9

what is the first diagnosis if a patient presents with Numbness & tingling along ulnar nerve distribution distal to elbow?

Answer 9

cubital tunnel

Question 10

what is the first diagnosis if a patient presents with Pain in anterior elbow & forearm worsened w/ wrist flexion combined w/ elbow flexion & forearm pronation?

Answer 10

pronator teres syndrome

Question 11

what is the first diagnosis if a patient presents with pain with elbow movement with sensations of catching or instability?

Answer 11

UCL Instability

Question 12

what is the first diagnosis if a patient presents with posterior elbow pain with elbow hyperextension?

Answer 12

possible valgus overload (extension overload)

Question 13

what criteria from a patient may lead you to believe they have a fracture?

Answer 13

Acute elbow injury
Adults >15 y/o
Children 3-15

Question 14

what criteria from a patient may lead you to believe they do not have a fracture?

Answer 14

Previous limited extension
no history of trauma
injury >72 hours old
Neuromuscular disease

Question 15

what is the capsular pattern for radiohumeral joint?

Answer 15

flexion, extension, supination & pronation

Question 16

what is the capsular pattern for proximal radiohumeral joint?

Answer 16

supination, pronation

Question 17

what is the capsular pattern for distal radiohumeral joint?

Answer 17

pain at extremes of rotation

Question 18

what is the common direction of preference & the progression?

Answer 18

extension
- Open chain
- Open chain w/ flick
- Loaded (closed chan)
- Loaded with patient generated overpressure

Question 19

what are the arthrokinematics for flexion at the humeroulnar joint?

Answer 19

anterior, anterior

Question 20

what are the arthrokinematics for extension at the humeroulnar joint?

Answer 20

posterior, posterior

Question 21

what are the arthrokinematics for flexion at the humeroradial joint?

Answer 21

anterior, anterior

Question 22

what are the arthrokinematics for extension at the humeroradial joint?

Answer 22

posterior, posterior

Question 23

what are the arthrokinematics for pronation at the proximal radioulnar joint?

Answer 23

anterior, posterior

Question 24

what are the arthrokinematics for supination at the proximal radioulnar joint?

Answer 24

posterior, anterior

Question 25

what is the diagnostic test for lateral epicondylitis?

Answer 25

+ Cozen’s Test (Resisted wrist extension - ECRB) + Mills Test (Stretch wrist extension - ECRL) + Maudsley Test (EDC) + pain palpation at lateral epicondyle

Question 26

what is the diagnostic test cluster for medial epicondylitis?

Answer 26

+ pain with resisted wrist flexion + pain with stretch of wrist flexors (PROM into wrist extension) +Golfer’s Elbow Test +pain with palpation of medial epicondyle/Common Flexor Tendon

Question 27

what test can you do when you suspect median nerve (pronator terms syndrome)?

Answer 27

Pronator teres test

Question 28

what test can you perform is ulnar nerve (cubital tunnel syndrome) is suspected?

Answer 28

Elbow flexion test, Tinel’s Test

Question 29

what test can you perform when radial nerve (PIN/Radial Tunnel Syndrome is suspected)?

Answer 29

ULTT palpation

Question 30

what are some differential diagnosis when ulnar nerve is involved?

Answer 30

Cubital tunnel syndrome Ulnar (Guyon’s) tunnel Syndrome C8 or T1 radiculopathy

Question 31

what are some differential diagnosis when median nerve is involved?

Answer 31

Pronator Teres Syndrome Anterior Interosseous Nerve (wrist & hand) Carpal Tunnel C6, C7 radiculopathy

Question 32

what are diagnostic test for radial tunnel syndrome?

Answer 32

+ULTT2b +TTP

Question 33

what are some differential diagnosis for radial nerve?

Answer 33

Cervical radiculopathy Lateral epicondylitis

Question 34

what are some test for UCL sprain/tear?

Answer 34

Valgus stress test Moving valgus stress test

Question 35

what are some test for RCL sprain/tear?

Answer 35

varus stress test