The Elbow

Question 1

Epicondylitis clinical features and tests - Tennis

Answer 1

Inflammation of the extensor tendon origins/lateral
Most common cause of elbow pain
Repetitive pronation/supination with elbow extended
Pain on wrist extension and gripping
Decreased grip strength

Localised tenderness over the LE on resisted wrist extension
Pain on maximal wrist flexion

Question 2

Epicondylitis clinical features and test - Golfers

Answer 2

Inflammation of the flexor origin/medial
Much less common than tennis
Repetitive wrist flexion/pronation
ME pain

Tender ME on resisted wrist flexion

Question 3

Epicondylitis investigations

Answer 3

X Ray normal

MRI- tendiosis

Question 4

Epicondylitis management

Answer 4

Conservative

• activity modification
• ice
• NSAID’s

Surgical
-release and debridement

Question 5

Elbow dislocation clinical features

Answer 5

Most common after shoulder
Usually posterolateral
10-20y

Axial loading and supination/external rotation and valgus force
Pain
Abnormal posture
Olecranon protrudes posteriorly

Question 6

Elbow dislocation investigations

Answer 6

X Ray

CT if complex

Question 7

Elbow dislocation management

Answer 7

Conservative

• reduction and splint at 90 5-7 days
• analgesia
• traction supination flexion

Surgical
-ORIF

Question 8

Cubical tunnel syndrome clinical features

Answer 8

2nd most common
Parasthesia of little and ulnar ring finger and ulnar dorsal hand
Exacerbation on cell phone use and repetitive elbow flexion
Night pain and parasthesia
Numbness
Weakness

Question 9

Cubical tunnel syndrome specific tests

Answer 9

Interosseous and first web space wasting 
Small and ring finger clawing
Decreased sensation 
Weak grasp
Weak pinch

Fromarts-> thumb IP flexion during pinch
Wartenburg-> small finger abduction and extension during attempted adduction
Tinnels
Weak spreading of fingers

Question 10

Cubital tunnel syndrome investigations

Answer 10

EMG decreased conduction velocity

Question 11

Cubital tunnel syndrome management

Answer 11

Conservative

• NSAIDs
• amitriptyline
• night time elbow splint
• activity modification

Surgical
-nerve decompression

Question 12

Olecranon bursitis clinical features

Answer 12

Over the ulnar in the posterior elbow 
Focal swelling 
Isolated trauma/occupational
?septic
Pain
Fluctuant

Question 13

Olecranon bursitis investigations

Answer 13

?infection
X Ray if trauma
Aspiration

Question 14

Olecranon bursitis management

Answer 14

Conservative

• NSAIDs
• steroids
• activity modification

Surgery
-bursectomy