Elbow Disorders

smoking, repetitive, forceful

Epicondylitis: Risk Factors

-_______

-Obesity

-Age 45-54

-__________ movement for at least two hours daily

-_________ activity (golf, tennis, construction)

extensors, lateral, carpi, brevis, supination, extension, epicondyle, extension, passive

Lateral Epicondylitis (Tennis Elbow): Background

-Inflammation of wrist __________ at lateral epicondyle

• Extensor ____ radialis _____ muscle is affected

-Mechanism of Injury:

• Overuse-repetitive ____________ and wrist _________

-S/S:

• TTP over lateral ___________ and proximal wrist extensors

• Pain with resisted wrist ___________

• Pain with ________ wrist flexion

-Diagnosis:

• Clinical

modification, brace, steroid, 6, 9-12

Lateral Epicondylitis: Treatment

-Activity ___________, ice, NSAIDs, counterforce ______, wrist splints, and PT are all first line options

-_______ injection, surgery is rarely indicated

-Indications for referral:

• Severe pain or significant dysfunction for a minimum of _ months

• Failure of conservative therapy for _-__ months

flexors, pronators, teres-flexor, pronation, epicondyle, flexion, passive

Medial Epicondylitis (Golfer’s Elbow): Background

-Inflammation of wrist _______/___________ at medial epicondyle

• Pronator _____-______ carpi radialis muscles

-Mechanism of Injury:

• Overuse-repetitive wrist flexion and ___________

-S/S:

• TTP over the medial ___________ and proximal wrist flexors

• Pain with resisted wrist _______ and pronation

• Pain with _________ wrist extension

clinical, activity, PT

Medial Epicondylitis: Diagnosis and Treatment

-Diagnosis:

• ________

-Treatment:

• _______ modification, rest, ice, NSAIDs, __

• Steroid injection

bursa, olecranon, trauma, pressure, overuse, RA, swelling, cellulitis

Olecranon Bursitis: Background

-Inflammation of the _____ that overlies the __________ process

-Mechanism of Injury:

• _____

• Prolonged _________ to area (think truck driver resting on elbow)

• _________ or strenuous act

• Crystal induced arthropathy

• Inflammatory arthritis (__)

• Septic bursitis

-S/S:

• TTP and ___________ over the olecranon

• Can be red and warm and appear like _____________

clinical, joint protection, aspiration, antibiotics

Olecranon Bursitis: Diagnosis and Treatment

-Diagnosis:

• _______

• Aspiration, if concerned for infection or gout

-Treatment:

• Ice, NSAIDs, _____ __________

• ___________ can sometimes be used for treatment if there is no improvement over 3-6 weeks

• ____________ if concerned for infection

ulnar, cubital, flexor carpi, flexion

Cubital Tunnel Syndrome: Background

-______ nerve compression in the ______ tunnel along the medial elbow. The nerve is compressed by the _____ ______ ulnaris

-Caused by trauma, leaning on elbow, prolonged _________, and joint pathologies

4th, 5th, pain, flexion, Tinel, MRI, splinting, decompression

Cubital Tunnel Syndrome: Clinical Diagnosis and Treatment

-S/S:

• Parathesias of the ___ and ___ digits

• Medial elbow ____, aggravated by elbow _________

• + ____ sign possible

-Diagnosis:

• Motor and sensory nerve conduction studies

• ___ and/or US

-Treatment:

• Activity modification

• ________ elbow

• Severe or refractory symptoms = ________________ surgery

FOOSH, pain, lateral, pronation, decreased

Radial Head and Neck Fractures: Background

-Mechanism of Injury:

• Fall onto an outstretched arm (______)

• Direct blow

-S/S:

• ____, TTP, and/or swelling over _______ elbow/radial head

• Pain with _________/supination

• ____________ elbow ROM

alignment, fat pads, occult, fragments

Radial Head/Neck Fracture: Diagnosis

-X-Ray

• Fracture

• Abnormal bony _________

• Elevated ___ ____ (sail sign) → caused by blood distending joint capsule, may be the only sign of an ______ fracture

• Small bone ___________ in joint

NSAIDs, sling, splint, ortho, displaced

Radial Head/Neck Fracture: Treatment

-Ice, _________

-Non-displaced → ____ vs posterior long arm ______ at 90 degrees (depending on severity)

-Refer to _____ for complex or __________ fractures → pt may need ORIF

Monteggia

What type of fracture is being described?

-Ulnar fracture with dislocation of the radial head

Galeazzi

What type of fracture is being described?

-Radius fracture with dislocation of the distal radiolunar joint