Elbow, wrist, hand ppt Flashcards
causes of anterior elbow pain
anterior capsule strain osteoarthritis bicep tendinopathy gout rhematoid arthritis
causes of lateral elbow pain
lateral epicondylitis
posterolateral rotatory instability
causes of medial elbow pain
medial epicondylitis
cubital tunnel syndrome
ulnar collateral ligament injury
valgus extension overload syndrome
causes of posterior elbow pain
osteoarthritis olecranon bursitis posterior impingement olecranon stress fracture triceps tendinopathy
toddler’s parents/babysitter swinging child by the arm. child keeps arm close to body. no trauma.
subluxation of the radial head
subluxation of the radial head
other name
most common age
cause
annular ligament slips out of the radial head and gets trapped in the radiohumeral joint
nursemaid’s elbow
1-5 yo
sudden pulling, falling, and arm twisting
PE findings for subluxation of the radial head
arm close to the body with elbow slightly flexed or fully extended with forearm pronated
management of subluxation of the radial head
hyperpronation
supination/flexion
medial epicondylitis
other name
cause
inner elbow pain - acute or chronic inflammation of flexor tendons due to some form of strenuous activity
golfer’s elbow
overuse injury from repeated motion (such as playing golf)
PE findings of medial epicondylitis
pain on medial aspect of the elbow over the medial epicondyle, tenderness wtih passive extension of the wrist and resisted flexion of wrist
management of medial epicondylitis
modify activity, bracing, NSAIDs
imaging, physical therpy, bracing/splinting
lateral epicondylitis
other name
cause
lateral elbow pain - acute or chronic inflammation of extensor tendons due to incorrect stroke mechanics
tennis elbow
overuse injury from repeated motion such as playing tennis, excessive hyperextension
PE findings of lateral epicondylitis
pain on the lateral aspect of the elbow
pain on palpation of the lateral epicondyle, tenderness with resisted wrist extension
management of lateral epicondylitis
modify activity, bracing or NSAIDs
imaging, physical therapy, bracing/splinting
olecranon bursitis
other name
causes
inflammation of the olecranon bursa which is located in the posterior aspect of the olecranon process of the ulna
miner’s elbow, student’s elbow
inflammatory arthritis, gout, trauma, hemorrhage, sepsis
PE of olecranon bursitis
pain and swelling on olecranon bursa, may be inflammatory versus infectious
able to distinguish between bursitis versus effusion if able to extend at elbow without severe pain - bursitis without effusion.
if pain with extension - effusion present
management of olecranon bursitis
RICE, NSAID, aspiration if fluid present with analysis of fluid
carpal tunnel syndrome
causes
condition caused by compression of median nerve
multifactorial but risk includes obesity, hypothyroidism, DM, repetitive movement/workplace factors, pregnancy, genetic, connective tissue disorder, female gender
PE findings of carpal tunnel syndrome
pain and paresthesia along the first three and half digits with the distribution along the route of median nerve is being compressed
specialty exam for carpal tunnel syndrome
tinels
phalens
treatment of carpal tunnel syndrome
wrist splint at night
EMG to evaluate extent of nerve degeneration, continued splinting, steroid injections, carpal tunnel release
dequervain tenosynovitis
cause
recurrent inflammation of the tendon and synovial sheath covering extensor pollicis brevis and abductor pollicis longus recurrent movement (new mother picking up child), idiopathic
PE findings of dequervain tenosynovitis
radial wrist pain (over the radial styloid) at base of thumb especially with movement of thumb
specialty exam for dequervain tenosynovitis
finkelstein test
