Elbow

Question 1

• 20-40
• m.c. cause of elbow pain
• Distal LE pain
• Can radiate up or down lat arm and
  into fingers 1-3
• Weak scapular stabilizers (LS, SA, Rh)
• Decrease in grip strength
• Elbow ROM = wnl
• (-) Ext/Sup

Answer 1

Lateral Epicondylitis

Test:
- Cozen’s (Rad. Dev, + Ext)
- Mills ( Pron. + Flex)
- MFET

Question 2

• 20-60, M (2:1)
• Distal M.E. pain
• Can radiate up or down medial arm
  and into fingers 4-5
• Hand weakness
• Elbow stiffness, Weak wrist

Answer 2

Medial Epicondylitis
aka - pitchers elbow, little leaguers elbow

Question 3

• Achy pain over cubital fossa
• Sensory loss over palm and 3 1/2
  digits
• Weak: wrist flexion, pronation,
  thumb flexion (cant make OK sign)
• Thenar muscle atrophy
• (-) repetitive pronation + supination

Answer 3

Pronator Teres Syndrome

*Differentiate

AINS:
- Pure motor loss of FDP, PQ, FDP
CTS:
- No PCN involvement
- (+) CTS tests

Question 4

• Pain over prox lat/post forearm
• +/- Weak: wrist/digit Ext, sup, thumb
  abd
• May see rad deviation with wrist ext
• Atrophy: posterior forearm
• (-) repetitive pronation + supination
• Sensory loss: none

Answer 4

Posterior interosseous nerve syndrome
aka “radial tunnel syndrome”

Question 5

• Pain prox medial elbow
• Weak: wrist flexion/ulnar dev (mild) +
  Intrinsic hand muscles + thumb Abd
• Atrophy: hypothenars
• Sensory loss: med forearm + palm
  and 4.5 - 5th
• (-) repetitive/sustained forearm flex

Answer 5

Ulnar nerve entrapment
aka “Cubital Tunnel Syndrome”

Question 6

Thumb test for nerve palsy:
Median?
Ulnar?
Radial?

Answer 6

• Flexion
• Adduction
• Abduction

Question 7

• M, Weight lifter/motor sports
• Tenderness at olecranon
• Pain with A/RROM Extension
• +/- swelling (dx bursitis)
• Management?

Answer 7

Tricep Tendinitis

*Bursitis = “students elbow”

Management:
Rest > ROM > Strength

Question 8

• M, 30-60
• Focal swelling at elbow
• +/- warmth, fever, tenderness
• (-) leaning on table to write
• slight decreased end-range elbow flex
• Management?

Answer 8

Olecranon Bursitis
“Student elbow” “Popeye elbow”

• Refer to GP for DX testing (septic vs
  non)
• PRICE

Question 9

Supracondylar fx which nerve?

Answer 9

Median nerve

Question 10

Median nerve palsy?

Answer 10

• Hand of benediction “bishops hand”
• Ape hand (thenar atrophy)

Question 11

Ulnar nerve palsy?

Answer 11

• Claw hand
• Hypothenar palsy

Question 12

Radial nerve palsy?

Answer 12

• Wrist drop