Elbow Pain

Question 1

Describe inspection of the elbow

Answer 1

Look for soft tissue swelling, nodules, erythema, indentation, hypotrophy, hypertrophy of muscles, scars, etc

Question 2

What should you palpate on the elbow during an exam?

Answer 2

Olecranon process posteriorly, lateral and medial epicondyle, radial head while pronating and supinating the forearm, cubital fossa

Question 3

Which nerve roots does the biceps reflex test?

Answer 3

C5-6

Question 4

Which nerve root does the triceps reflex test?

Answer 4

C6-7

Question 5

Which nerve roots does the brachioradialis reflex?

Answer 5

C5-6

Question 6

Which pulses are tested in the UE?

Answer 6

Radial and brachial

Question 7

Subluxation of the radial head is the most common in?

Answer 7

Children usually ages 1-5

Question 8

What is the cause of subluxation of the radial head (nursemaid’s elbow)?

Answer 8

Sudden pulling, falling and arm twisting

Causes annular ligament to slip out of the radial head and gets trapped in the radio humeral joint

Question 9

What is the classic presentation/exam findings for subluxation of the radial head?

Answer 9

Arm close to the body with elbow slightly flexed or fully extended with the forearm pronated

Question 10

What is the cause of medial epicondylitis (golfer’s elbow)?

Answer 10

Overuse injury from repeated motion such as playing golf

Acute or chronic inflammation of flexor tendons due to some form of strenuous activity

Question 11

What is the classic presentation/exam finding for medial epicondylitis?

Answer 11

Pain on medial aspect of the elbow over the medial epicondyle, tenderness with passive extension of the wrist and resisted flexion of the wrist

Question 12

What is the cause of lateral epicondylitis (tennis elbow)?

Answer 12

Overuse injury from repeated motion such as playing tennis, excessive hyperextension
Acute or chronic inflammation of extensor tendons due to incorrect stroke mechanics

Question 13

What is the classic presentation/exam finding for lateral epicondylitis?

Answer 13

Pain on lateral aspect of the elbow

Pain on palpation of the lateral epicondyle, tenderness with resisted wrist extension

Question 14

What is the cause of olecranon bursitis?

Answer 14

Also known as Miner’s elbow or students elbow
Inflammatory arthritis, gout, trauma, hemorrhage, sepsis
Inflammation of the olecranon bursa which is located in the posterior aspect of the olecranon process of the ulna

Question 15

What is the classic presentation/exam findings for olecranon bursitis?

Answer 15

Pain and swelling on olecranon bursa, may be inflammatory vs infections
Able to distinguish between bursitis vs effusion, if able to fully extend at elbow without severe pain then bursitis without effusion
If effusion presents pain with extension due to increased pressure at the joint

Question 16

What is the ROM for the ulnar humeral joint?

Answer 16

Flexion and extension

Question 17

What is the movement of the radial head during wrist pronation?

Answer 17

Moves posteriorly

Question 18

What is the movement of the radial head during wrist supination?

Answer 18

Moves anteriorly

Question 19

What is the motion of the radial ulnar joint?

Answer 19

Glides in response to wrist motion

Question 20

What is the mechanism for posterior radial head somatic dysfunction?

Answer 20

Falling prone

Question 21

What is the mechanism for anterior/supinated radial head somatic dysfunction?

Answer 21

Falling supine

Question 22

Describe the carpal tunnel

Answer 22

Carpal bones must form and maintain an arch
The transverse carpal ligament must stay flexible
-Can be stretched by flexor tendons

Question 23

What are the movements of the MCP and IP joints?

Answer 23

Flexion, extension, adduction, abduction, internal and external rotation, circumduction