Special Tests of the Elbow Flashcards
1
Q
Medial Collateral Stress Test
A
- Anterior band of the MCL tightens with 20-120 of flexion
- Anterior band of the MCL is lax in full extension
- Posterior band is taut in flexion beyond 55
2
Q
Anterior Band Test
A
- Patient supine
- Flex elbow to 20-30 degrees
- Apply valgus stress continuously
3
Q
Posterior Band Test
A
- Patient is seated with arm in shoulder flexion, elbow flexion beyond 55 and forearm supination
- Clinician pulls downward on the patient’s thumb
- Positive test is reproduction of the patient’s pain
4
Q
Lateral Pivot Shift Apprehension Test
A
- Used to diagnose posterolateral rotatory instability
- Patient supine with the involved UE overhead
- Clinician grasps the patient’s wrist and elbow
- Elbow is supinated with a mild force at the wrist, and a valgus moment and compressive force is applied to the elbow during flexion
- Positive test= apprehension response
5
Q
Lateral Collateral Stress Test
A
- Patient supine with elbow positioned in 5-30 short of full extension
- Clinician stabilizes the humerus and adducts the ulna, producing a varus force at the elbow
- End-feel is noted
6
Q
Cozen’s Method 1
A
- Clinician stabilizes the patient’s elbow with one hand
- Patient is asked to pronate the forearm and extend/ RD the wrist against resistance
- Positive test is reproduction of pain at the lateral epicondyle
7
Q
Mill’s Method 2
A
- Clinician palpates the patient’s lateral epicondyle with one hand
- Pronate the patient’s forearm while fully extending the wrist and elbow
- Positive test is reproduction of pain in the lateral epicondyle region
8
Q
Maudsley Medthod 3
A
- Patient is seated
- Using one hand, the clinician grasps the patient’s wrist
- Other hand resists third digit extension
- Positive test is reproduction of pain along the lateral epicondyle
9
Q
Medial Epicondylitis Test
A
- Clinician palpates the medial epicondyle
- Clinician supinates the forearm and extends the wrist/elbow with the other hand
- Positive test is reproduction of pain along the medial epicondyle
10
Q
Elbow Flexion Test
A
- Patient in sitting or standing, UEs in anatomic position
- Patient asked to depress both shoulder, flex both elbows maximally and supinate the forearms while extending the wrists
- Maintain this position for 3-5 minutes
- Positive test= paresthesia in the ulnar distribution of the forearm or hand
11
Q
Pressure-Provocative Test
A
- Pressure is applied proximal to the cubital tunnel, with the elbow held in 20 flexion and supinated
- Positive test= tingling or paresthesia in the ulnar distribution of the forearm and hand
12
Q
Percussion Test/Tinel’s Sign
A
- Clinical locaes the groove between the olecranon and the medial epicondyle
- This groove is tapped 4-6 times by the index finger of the clinician
- Positive test= tingling sensation in the ulnar distribution distal to the tapping point
13
Q
Elbow Extension Test
A
- Tests for elbow fracture
- Patient positioned supine and asked to extend the elbow
- Patient’s inability to fully extend the elbow is suspect for elbow fracture
14
Q
Moving Valgus Stress Test
A
- Patient in sitting
- Clinician positions the patient’s shoulder in 90 of abduction and 120 of elbow flexion
- Clinician applies a modest valgus stress to the elbow until the shoulder reaches full ER
- While applying a constant valgus stress, the elbow is quickly extended to 30 degrees
- Positive test (for chronic MCL tear)= reproduction of medial elbow pain when forcible extending the elbow from a flexed position between 120-70
15
Q
Biceps Squeeze Test
A
- Tests for rupture of the distal biceps tendon
- Patient seated with the forearm resting in the patient’s lap
- Elbow flexed to approximately 60-80, forearm in slight pronation
- Clinician squeezes the biceps firmly
- Positive test= loss of forearm supination
