elbow subjective exam Flashcards
what are examples of things that we ask in the subjective examination?
-reason for attendance
-body chart
-pain and behaviour of symptoms
-any other symptoms eg weakness, pins and needles, swelling etc
-history of their condition
-past medical history
-family history
-drug history
-social history - work & lifestyle
-patient goals & expectations
what is the body chart?
-area of current symptoms - pain, stiffness etc, tick symptom free areas
-depth and quality of pain
-frequency - constant, intermittent etc
-intensity/ severity - NRS
-irritability
-abnormal sensations
What are important things to look out for in the elbow subjective exam?
-elbow stiffness
-elbow pain
-elbow instability
what age groups and working populations can commonly have elbow pain?
-paediatrics & young athletes
-keyboard working population can have elbow problems
why can elbow pain patients often report stiffness post symptom onset?
- degenerative OA
-ulnar nerve injury
-systemic diseases
-congenital conditions
-burns
-head injury / neurological changes
what will patients with osteo-arthritis in the elbow complain of ?
-report stiffness / lack of range and often hard bony swelling
-often posterior elbow pain
-pain on extension
what is the capsular pattern of the elbow?
-the capsular pattern usually involves limitations I. both flexion & extension with more restriction in extension
-greater restriction in the ability to fully extend the elbow compared to flexion
what are examples of systemic conditions that can cause elbow stiffness?
-RA
-Gout (type of arthritis that leads to formation of crystals in the joint)
-septic arthritis
what is arthrogryposis?
rare condition characterised by multiple joint contractures (stiffness) and muscle weakness
what are congenital radial ulnar synostosis?
the radius and ulna are fused together - this can lead to limitations to rotation & movements of the arm
what locations in the elbow can have pain?
-lateral
-medial
-anterior
-posterior
what characteristics are associated with the onset of tendinopathy?
-new change in activity
-increased activity with grip
-increased tissue loading time
-changes in training / technique / work station
-faulty wrist position
-activities that involve grip
Describe characteristics of an unstable elbow
-infrequent compared to shoulder
-traumatic - often with fracture dislocation
-repeated overhead activity eg throwing
-inflammatory arthritis
-may hear a ‘pop’ and describe feeling of clicking/ instability and locking
what is cubital tunnel syndrome?
- can occur when the ulnar nerve becomes compressed or irritated
what is supinator syndrome?
-compression or entrapment of the deep branch of the radial nerve as it passes through the supinator muscle in the forearm
