WEBVTT

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(English captions by Andrea Matsumoto from
the University of Michigan)

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To ensure a thorough assessment of the elbow
it is prudent to develop a systematic approach.

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The following is a suggested order of exam
that incorporates the common techniques for diagnosing

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musculoskeletal elbow injuries.

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The elbow exam begins with inspection.

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Assess for asymmetry, muscular atrophy, or
skin changes.

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Next evaluate active range of motion.

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If pain or limitation exists, repeat the range
of motion passively.

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Follow the active range of motion by checking
resistive strength.

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Range of motion includes flexion, extension,
supination and pronation.

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Next palpate anatomic landmarks.

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The olecranon, the medial epicondyle, the
lateral epicondyle, the radial head, the location

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of the posterior interosseous nerve, and the
biceps tendon in the antecubital fossa.

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Specific testing of the elbow to evaluate
for musculoskeletal injuries may include but

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is not limited to the following tests.

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Ulnar collateral ligament stability can be
tested at 0 and 30 degrees by applying a valgus

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force to the elbow.

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Radial collateral ligament stability can also
be tested at 0 and 30 degrees of flexion by

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applying a varus force to the elbow.

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Laxity indicates partial or complete ligamentous
tear.

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Cozen's test assesses for lateral epicondylitis.

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Lateral elbow pain with resisted wrist extension
is a positive test.

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Maudsley's test assesses for lateral epicondylitis.

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Lateral elbow pain with resisted third finger
extension is a positive test.

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Perform a Tinel's at the cubital tunnel
attempting to recreate pain, numbness, and

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tingling over the ulnar nerve.

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In conclusion of the elbow exam it's important
to document neurovascular status.

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Here we demonstrate a brief exam.

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With resisted wrist extension for radial nerve.

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Check resisted opposition strength of the
thumb to check the median nerve and resisted

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digit abduction for the ulnar nerve.

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Evaluate for the radial pulse and capillary
refill.

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Further neurovascular exam may be indicated
by history.