S8) The Elbow Flashcards
What is the elbow joint?
- The elbow is the joint connecting the anatomical arm to the forearm
- It is marked by the olecranon process and the medial and lateral epicondyles
Classify the elbow joint in terms of its structure and function
- Structurally, it is classed as a synovial joint
- Functionally, it is classed as a hinge joint
Describe the articulating surfaces of the elbow
- Trochlear notch of ulna articulates with the trochlea of humerus
- Head of the radius articulates with the capitulum of humerus
Which other joint is also found within the joint capsule of the elbow?
Proximal radioulnar joint
Describe the movement of the elbow joint and identify the muscles involved
- Extension: triceps brachii and anconeus
- Flexion: brachialis, biceps brachii, brachioradialis
Discuss the stability of elbow joint
- Like all synovial joints, the elbow joint has a strong and fibrous capsule enclosing and strengthening the joint
- The joint capsule is thickened medially and laterally to form collateral ligaments, which stabilise the flexing and extending motion of the arm
Describe the anatomical position of the collateral ligaments of the elbow joint
- The radial collateral ligament lies on the laterally, extending from the lateral epicondyle and blending with the annular ligament of the radius
- The ulnar collateral ligament originates from the medial epicondyle, and attaches to the coronoid process and olecranon of the ulna
What is a bursa and what does it do?
- A bursa is a membranous sac filled with synovial fluid
- It acts to cushion the moving parts of a joint, preventing degenerative damage and reducing friction
Identify the 3 elbow bursa of clinical importance
Describe the anatomical location of the 3 elbow bursa
- Intratendinous bursa is located within the tendon of the triceps brachii
- Subtendinous bursa is located between the olecranon and the tendon of the triceps brachii
- Subcutaneous bursa is located between the olecranon and the overlying connective tissue
Identify the common injuries to the elbow and wrist joint
- Acute/trauma: fractures, dislocations
- Chronic/degenerative: arthritis, tendinopathies
Identify 4 acute / traumatic clinical conditions affecting the elbow
- Elbow dislocation
- Supracondylar fracture
- Radial head/neck fractures
- Radial head subluxation
Identify 6 chronic / degenerative clinical conditions affecting the elbow
- Osteoarthritis
- Rheumatoid arthritis
- Lateral elbow tendinopathy
- Medial elbow tendinopathy
- Olecranon bursitis
- Gout tophi
What is an elbow dislocation?
- An elbow dislocation is a clinical condition in which the joint surfaces of the elbow are separated and presents with pain, deformity or loss of function
- It is the 2nd most common dislocation and results from FOOSH
What is a supracondylar fracture of the distal humerus?
- A supracondylar humerus fracture is a fracture of the distal humerus just above the elbow joint which occurs from FOOSH
- It is usually transverse/oblique above the medial and lateral condyles and epicondyles and involves neurovascular compromise – paraesthesia, radial pulse, capillary return
What are radial head/neck fractures?
- Radial head/neck fractures are the commonest elbow fracture and involves a fracture to the proximal radius due to FOOSH
- It presents with lateral pain, modest swelling or loss of range
What is radial head subluxation?
- Radial head subluxation (nursemaid’s elbow) is a clinical condition in which the radial head is dislocated from the annular ligament in the elbow joint
- It commonly occurs in young children due to longitudinal traction along extended arm
What is elbow osteoarthritis?
- Elbow osteoarthritis is a degenerative disease of the articular cartilage in the elbow joint that can cause pain and stiffness
- It can be primary (degeneration without a cause) or secondary (post-traumatic)
What is Rheumatoid arthritis?
- Rhematoid arthritis is a systemic autoimmune disease causing long-term stiffness, swelling and pain in the joints of the body
- Symptoms are due to inflammation of the synovium of small and large joints
In terms of swellings around the elbow, what are rheumatoid nodules?
- Rheumatoid nodules are firm, noticeable lumps that form underneath the skin of some rheumatoid arthritis patients
- These lumps generally form on/near the base of the arthritic joints and are the commonest extra-articular manifestation of RA
In terms of swellings around the elbow, what is olecranon bursitis?
- Olecranon bursitis (student’s elbow) is the inflammation of the bursa in the elbow joint due to trauma or friction
- It presents with pain, redness and swelling around the elbow and can become infected
In terms of swellings around the elbow, what is gout tophi?
- Gout tophi is a disorder of nucleic acid metabolism leading to hyperuricaemia and urate crystal deposits in the joints
- It leads to recurrent attacks of arthritis and mainly affects soft tissues e.g. ear, elbow, achilles tendon
What is lateral elbow tendinopathy?
- Lateral elbow tendinopathy (tennis elbow) is a degenerative condition that can cause significant functional impairment in working-age patients
- It is the commonest cause of elbow pain and involves pathology in the common extensor tendon
What is medial elbow tendinopathy?
- Medial elbow tendinopathy (golfer’s elbow) is a degenerative condition / overuse injury predominantly seen in athletes
- It is 10x less common than LET and involves pathology in the common flexor tendon
