Elbow examination

Question 1

look

Answer 1

The carrying angle may be asymmetrical in a fracture
Effusion – swelling over lateral aspect of the joint
Bursitis – swelling over the olecranon process
Gouty tophi; psoriatic plaques; rheumatoid nodules on the proximal extensor surface of the forearm

Question 2

feel

Answer 2

both sides

Palpate the bony prominences of the olecranon, lateral and medial epicondyle, and radial head.
Palpate between the bony contours.
Note swelling or pain.
With elbow in extension, valgus stress the medial collateral ligaments and varus stress the lateral collateral ligaments.

Question 3

move

Answer 3

Flexion (0-145o)
With the shoulder abducted at 90o and palm facing up, look for hyperextension of the elbow (>10o indicates hypermobility)
Pronation (0-85o) Supination (0-90o)

Question 4

tests

Answer 4

Suspected lateral epicondylitis (tennis elbow)
Suspected medial epicondylitis (golfer’s elbow)
Suspected cubital tunnel syndrome – Tinel’s test
Suspected ulnar nerve palsy – Froment’s test