Elbow Ortho Tests

Question 1

Valgus and Varus stress test

Part of basic examination

Aim: Assesses the medial and collateral ligaments of the elbow

Answer 1

Action: Same as medial and lateral gapping of the humero-ulna joint. -Proximal end of pt radius with driving hand, also palpating medial olecranon (palpating the medial humero-ulna joint). -Op then drops elbow into slight flexion, and drives through the elbow gently towards the plinth. -Repeat on other side

+ve: Pain/apprehension over corresponding side, or obvious laxity

Question 2

Tennis Elbow Test (Cozens)

Answer 2

Aim: To test for contractile lesions of Common Extensor Origin

Action: Active resisted wrist extension and radial deviation, with thumbs palpating CEO and CFO.
-Pt elbow extended, forearm pronated
-Pt extends wrist and radial deviates against Op counter pressure

+ve: Pain over lateral aspect of elbow

Question 3

Golfer’s Elbow Test

Answer 3

Aim: To test for contractile lesion of Common Flexor Origin (wrist flexors)
-Associated with repetitive flexion and pronation movements

Action: Active resisted contraction of patients wrist flexion

+ve: Reproduction of pain over medial elbow
-Ulnar nerve symptoms may co-exist due to proximity of CFO and Ulnar nerve

Question 4

Tinel’s test (peripheral nerve entrapment test)

Answer 4

Aim: To assess for compression neuropathy of ulnar nerve in cubital tunnel

Action: -Palpate proximal to cubital tunnel to locate ulnar nerve
-Gently tap (percuss) the area with fingers or patella hammer
-Slight elbow flexion may make the ulnar nerve slightly more prominent and easier to palpate

+ve: Paraesthesia in ulnar nerve distribution (lateral palm, on level with pinky finger, lateral half of 4th digit all the way up, front and back).