Elbow Pathologies

Question 1

The elbow joint consists of which joints?

Answer 1

1. Humero-ulnar joint (flexion/extension)
2. Radio-capitallar joint (supination/pronation)

Question 2

Which muscle powers extension at the elbow joint?

Answer 2

Triceps brachii

Question 3

Which muscles power flexion at the elbow joint?

Answer 3

1. Brachialis
2. Biceps brachii

Question 4

Supination at the elbow joint is achieved by which muscles?

Answer 4

1. Biceps brachii
2. Supinator

Question 5

Pronation at the elbow joint is achieved by which muscles?

Answer 5

1. Prontaor teres
2. Pronator quadratus

Question 6

Where is the insertion site for the triceps muscle?

Answer 6

Olecranon

Question 7

Where is the insertion site for the brachialis?

Answer 7

Coronoid process

Question 8

What is the insertion site for the biceps brachii?

Answer 8

Bicipital tuberosity of the radius

Question 9

Where does the common extensor origin arise from?

Answer 9

Lateral epicondyle of the humerus

Question 10

Where does the common flexor origin arise from?

Answer 10

Medial epicondyle

Question 11

What is the term given to the area where a muscle inserts?

Answer 11

Enthesis

Question 12

What is the elbow more commonly affected by, RA or OA?

Answer 12

RA

Question 13

Tennis elbow is a ________ epicondylitis

Answer 13

Lateral

Question 14

Tennis elbow arises due to those who reguarly perform movements involving what?

Answer 14

Resisted extension at the wrist

(it may also occur as a degenerative process)

Question 15

What does the pathogology show for tennis elbow?

Answer 15

Micro-tears in the common extensor origin

Question 16

What are the clinical features of tennis elbow?

Answer 16

1. Painful and tender lateral epicondyle
2. Pain on resisted middle finger and wrist extension

Question 17

What is the treatment for lateral epicondylitis?

Answer 17

1. Rest (most cases are self limiting)
2. Physiotherapy
3. NSAIDs
4. Steroid injections
5. Use of an elbow clasp (brace)
6. Ultrasound therapy (no proven efficacy)
7. Surgery - division and/or excision of some fibres of the common extensor origin - only for the most severe cases

Question 18

Golfer’s elbow is a _________ epicondylitis

Answer 18

Medial

Question 19

What is golfer’s elbow a result of?

Answer 19

Repeated strain or degeneration of the common flexor origin

Question 20

What is the treatment for golfer’s elbow?

Answer 20

1. Rest
2. Physio
3. NSAIDs
4. Injection
5. Surgery (for the most severe cases)

Question 21

Why is injection in medial epicondylitis dangerous?

Answer 21

It can risk injury to the ulnar nerve

Question 22

Since primary OA of the elbow is uncommon, when may it occur most frequently?

Answer 22

After trauma

Question 23

If non-operative management of arthritis of the radio-capitellar joint, what is the treatment?

Answer 23

Surgical excision of the radial head

(good pain releif and minimal functional limitation)

Question 24

If RA or OA of the humero-ulnar joint cannot be treated with conservative management, what is the surgical option?

Answer 24

Total elbow replacement

Question 25

If a patient has a total elbow replacement, what is the restriction after surgery and onwards?

Answer 25

Lifting in this limb must not exceed 2.5kg