Elbow Joint Conditions

Lateral Epicondylitis (Tennis Elbow)

• Condition: chronic degenerative condition of ECRB at its proximal attachment to lateral epicondyle of humerus

• Evaluation/ obs:

  • Repetitive wrist extension or strong grip with the wrist extended, overloading of ECRB

  • Painful passive wrist flexion and active wrist extension

• Special test:

  • Cozen’s test

  • Mill’s test

  • Maudsley’s test

Medial Epicondylitis (golfer’s elbow)

• Condition: Degenerative condition of pronator teres and flexor carpi radialis at medial epicondylitis of the humerus

• Examination/ obs

  • Occurs overuse in sports like baseball, pitching, driving golf swings, and swimming, occupations that require strong grip and excessive pronation of forearm

  • Painful passive wrist extension and active wrist flexion

• Special tests

  • Medial epicondylitis test

Supracondylar Fx

• Condition: distal humeral fracture

• Examination/ obs

  • Common in kids

  • Typically AIN (branch of median nerve), and brachial artery involvement

  • Complications: Volkmann’s Ischemic contracture, gunstock deformity (reduced carrying angle), high incidence of malunion

  • Requires open reduction internal fixation (ORIF)

Pulled elbow syndrome/nursemaid’s elbow

• Condition: longitudinal traction on an extended elbow → partial slippage of annular ligament over the head of the radius and radial capitular joint

• Examination/ obs

  • Age: 2-3

  • Position of arm- arm at side, with hand pronated (palm down)

  • Radial nerve can get injured

Olecranon Bursitis

• Condition: swelling over posterior elbow

  • ie) Students elbow, elbow bursitis

Anterior Interosseous nerve syndrome

• Condition: wrist of flexor pollicis longus (FPL) & flexor digitorum profundus (FDP) to index finger

• Weakness of pronator quadratus

Distal Biceps tendon rupture

• Condition: rupture of the distal biceps tendon

• Examination/ obs:

  • Swelling

  • Ecchymosis

  • palpable gap in biceps tendon

  • weak elbow flexion & supination

Myositis ossification

• Common in brachialis muscle as result of trauma, aggressive stretching

• Avoid stretching, massage, resistive exercises, Heat

Brachialis Strain

• Pain on anterior aspect of distal part of the arm, possible tenderness in muscle belly

• Painful resisted elbow flexion with forearm pronation