Elbow examination

Question 1

In the elbow examination, what do we GENERALLY INSPECT?

Answer 1

Surrounding area:
Slings

Patient:
Signs of discomfort

Question 2

In the elbow examination, what do we LOOK for on INSPECTION?

Answer 2

Overall alignment - normal carrying angle?
Symmetry - elbow should be flexed at 10 degrees
Deformity
Scars - medial epicondylar = ulnar nerve surgery, check olecranon process for olecranon surgery
Wasting - check forearm and upper arm
Swelling - check behind radial head, check for olecranon bursitis
Skin changes - thickening? nodules? plaques? erythema? bruising?

Question 3

In the elbow examination, what do we FEEL?

Answer 3

Temperature:
Above, over and below joints, on anterior and posterior side of joint

Structures:
Olecranon process 
Check for boggyness over olecranon that may indicate effusion due to olecranon bursitis
Medial and lateral epicondyle
Radial head
Bicep tendon
Ulnar nerve

Question 4

In the elbow examination, what MOVEMENTS do we assess?

Answer 4

Functionality:
Hands behind head
Hands to mouth - left and right

Elbow flexion and extension

Pronation and supination

Question 5

In the elbow examination, what SPECIAL TESTS do we perform?

Answer 5

Golfer’s elbow (medial epicondylitis) test:
Bend arm at 90 degrees
Passively EXTEND wrist
Resisted wrist flexion - positive test if pain on medial epicondyle

Tennis elbow (lateral epicondylitis) test:
Bend arm at 90 degrees
Passively FLEX wrist
Resisted wrist extension - positive if pain on lateral epicondyle

Question 6

In the elbow examination, what JOINT ABOVE do we test?

Answer 6

Shoulder joint - abduction

Question 7

In the elbow examination, what NEUROVASCULATURE do we test?

Answer 7

Power:
Abduction of little finger - ulnar nerve
Abduction of thumb - median nerve
Wrist extension - radial nerve

Sensation:
Lateral aspect of little finger - ulnar nerve
Palmar surface of thumb - median nerve
Dorsum surface of thumb - radial nerve

Vascular:
Radial pulse