Elbow Special Tests

ligament instability test

purpose: to identify ligament laxity or restriction

description: patient sitting or supine, elbow placed in 20*-0* of flexion. valgus force placed through elbow tests UCL. varus force test RCL

result: primary finding is laxity but pain may be present

lateral epicondylitis (Cozen’s) test

purpose: identify lateral epicondylitis

description: patient is sitting with elbow in 90* flexion then asked to actively make fist, pronate the forearm, and radially deviate and extend the wrist while the examiner resists the motion

result: sudden severe pain in the area of the lateral epicondyle of the humerus is a positive sign

Mill’s test

purpose: identify lateral epicondylitis

description: while palpating lateral epicondyle, examiner passively pronates the patient’s forearm, flexes the wrist fully, and extends the elbow

result: pain over the lateral epicondyle of the humerus indicates a positive test

Maudsley’s test

purpose: identify lateral epicondylitis

description examiner resists extension of the third digit of the hand distal to the proximal interphalangeal joint, stressing the extensor digitorum muscle and tendon

result: positive test is indicated by pain over the lateral epicondyle of the humerus

elbow flexion test

purpose: identify cubital tunnel syndrome

description: patient is asked to fully flex the elbow with extension of the wrist and 90* shoulder girdle abduction and depression and to hold this position for 3-5 minutes. symptoms should develop in less than 5 seconds

result: tingling or paresthesia in the ulnar nerve distribution of the forearm and hand indicates a positive test. the test helps determine whether a cubital tunnel syndrome is present

medial epicondylitis test

purpose: identify medial epicondylitis

description: while examiner palpates patient’s medial epicondyle, patient’s forearm is passively supinated and the examiner extends the elbow and wrist

result: positive sign is indicated by pain over the medial epicondyle of the humerus

Tinel’s sign (of the elbow)

purpose: identifies dysfunction of ulnar nerve at olecranon

description: the area of the ulnar nerve in the cubital tunnel is tapped

result: positive sign is indicated by a tingling sensation in the ulnar distribution of the forearm and hand distal to the point of compression of the nerve. test indicates the point of regeneration of the sensory fibers of the nerve. the most distal point at which the patient feels abnormal

pronator teres syndrome test

purpose: identify median nerve entrapment within pronator teres

description: the patient sits with the elbow flexed to 90*. examiner strongly resists pronation as the elbow is extended

result: tingling or paresthesia in the median nerve distribution in the forearm and hand indicates a positive test