elbow examination

Question 1

subsections of the elbow examination and essentially any ortho examination

Answer 1

introduction
inspection
palpation 
movement 
special tests
thanks the patient and presents

Question 2

introduction

Answer 2

wash hands, full intro, check pt name, full explanation and consent

• PT can keep a t shirt on, just need to have the elbows fully exposed. but ideally you should be able to see the entire limb
• ask about elbow pain

Position patient – palms facing forwards with arms by their side (anatomical position)

Question 3

inspection

Answer 3

Inspect the front to check the carrying angle, from the side to check for a fixed flexion deformity, and from behind and on the inside to check for scars, swellings, rashes,rheumatoid nodules and psoriatic plaques.

Carrying angle – 5-15 degrees – females tend to have more significant carrying angles than males

Psoriatic plaques – well defined pink / red elevated lesions with silvery scale

Question 4

palpation

Answer 4

• temperature

- lateral and medial epicondyles and olecranon for tenderness

Question 5

movement

Answer 5

These are flexion, extension, pronation and supination. Once these have been assessed actively they should be checked passively feeling for crepitus.

Elbow flexion - 145º

Elbow extension – 0º

Pronation – 70º

Supination – 85º

Question 6

special tests

Answer 6

check for tennis elbow and golfer’s elbow.

Tennis elbow localises pain over the lateral epicondyle, particularly on active extension of the wrist with the elbow bent. Golfer’s elbow pain localises over the medial epicondyle and is made worse by flexing the wrist. Check each of these individually to eliminate them.

to finish:
Examine the joint above & below (shoulder / wrist)

Perform a full neurovascular examination of the upper limbs

Request X-rays of the joint if you suspected pathology

Perform blood tests for markers of inflammation / autoantibodies (e.g. CRP/ Anti-CCP / etc)