Elbow Examination

Question 1

1. General inspection

Answer 1

Discarded sling

Signs of pain

Question 2

2. Look

Answer 2

Alignment and symmetry - usually 10° of flexion
Deformity
Skin changes 
Wasting
Swelling

Question 3

3. Skin changes

Answer 3

Scars (ulnar nerve surgery @ medial epicondyle, olecranon surgery)
Thickening 
Nodules 
Plaques
Erythema
Bruising

Question 4

4. Wasting

Answer 4

Muscles of forearm

Upper arm

Question 5

5. Swelling

Answer 5

Effusion (behind radial head)

Olecranon bursitis

Question 6

6. Feel

Answer 6

Elbow @ 90°
(Looking for swelling)
Behind radial head
Medial epicondyle
Lateral epicondyle 
Olecranon process 
Ulnar nerve

Question 7

7. Move

Answer 7

Hands behind head (flexion)
Hands to mouth
Extension - look for hyperextension
Pronation and supination (elbows in and flexed)

Question 8

8. Special Tests

Answer 8

Tennis elbow - pronation, elbow flexed, extend elbow
Positive = tingling @ lateral epicondyle

Golfers elbow - supination, elbow flexed, extend elbow
Positive = tingling @ medial epicondyle

Question 9

9. Joint above

Answer 9

Shoulder abduction and external rotation

Internal rotation - hands behind back

Question 10

10. Neurovascular

Answer 10

Radial and ulnar pulses
Capillary refill
Radial - don’t let me push cocked wrists
Median - don’t let me break thumb to little finger
Ulnar - don’t let me push abducted little finger