Polk's Test: Difference between revisions
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<div class="editorbox"> '''Original Editor '''- [[User:Sanne Delporte|Sanne Delporte]] | |||
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== Definition/Description == | == Definition/Description == | ||
Polk’s test is an easy to learn, easy to perform and simple to interpret test that can help the clinician differentiate between [[Lateral Epicondylitis|Lateral Epicondylitis]] and [[Medial Epicondylitis|Medial Epicondylitis]].<br>It aids the clinician in establishing a working diagnosis and also serves as an educational tool for the patient in helping them to better understand their condition and avoid the specific activities that aggravate the injury<ref name="Polkinghorn"> | Polk’s test is an easy to learn, easy to perform and simple to interpret test that can help the clinician differentiate between [[Lateral Epicondylitis|Lateral Epicondylitis]] and [[Medial Epicondylitis|Medial Epicondylitis]].<br>It aids the clinician in establishing a working diagnosis and also serves as an educational tool for the patient in helping them to better understand their condition, and to avoid the specific activities that aggravate the injury<ref name="Polkinghorn">Polkinghorn BS. A novel method for assessing elbow pain resulting from epicondylitis. Journal of Chiropractic Medicine. 2002;1:117-121.</ref>. | ||
== Clinically Relevant Anatomy == | == Clinically Relevant Anatomy == | ||
'''Wrist extensor group''' | '''Wrist extensor group''' | ||
* M. extensor digitorum | * [[Extensor Digitorum Communis|M. extensor digitorum]] | ||
* M. extensor digiti minimi | * [[Extensor Digiti Minimi|M. extensor digiti minimi]] | ||
* M. extensor carpi ulnaris<br>All these muscles have the same origin: the lateral epicondyle. | * [[Extensor Carpi Ulnaris|M. extensor carpi ulnaris]]<br>All these muscles have the same origin: the lateral epicondyle. | ||
'''Wrist flexor group''' | '''Wrist flexor group''' | ||
* [[Pronator Teres|M. pronator teres]] | * [[Pronator Teres|M. pronator teres]] | ||
* M. flexor digitorum superficialis | * [[Flexor Digitorum Superficialis|M. flexor digitorum superficialis]] | ||
* M. flexor carpi radialis | * [[Flexor Carpi Radialis|M. flexor carpi radialis]] | ||
* M. flexor carpi ulnaris | * [[Flexor Carpi Ulnaris Muscle|M. flexor carpi ulnaris]] | ||
* M. palmaris longus<br>All these muscles have the same origin: the medial epicondyle. | * [[Palmaris Longus|M. palmaris longus]]<br>All these muscles have the same origin: the medial epicondyle. | ||
== Purpose == | == Purpose == | ||
The use of Polk’s test may help the clinician to diagnostically differentiate between [[Lateral Epicondylitis|Lateral Epicondylitis]] en [[Medial Epicondylitis|Medial Epicondylitis]], 2 of the most common causes of elbow pain.<br>Polk’s test also helps to definitively | The use of Polk’s test may help the clinician to diagnostically differentiate between [[Lateral Epicondylitis|Lateral Epicondylitis]] en [[Medial Epicondylitis|Medial Epicondylitis]], 2 of the most common causes of elbow pain.<br>Polk’s test also helps to definitively identify the method of lifting that is best to be avoided by the patient <ref name="Polkinghorn" />.<br><br>The mechanism of the Polk’s test is very straightforward. When the hand grasps an object, tension is placed on both the flexors and the extensors of the wrist. The motion of lifting an object, aggravates the tension on the primary affected muscle group with resulting mechanical strain at the inflamed musculotendinous attachment site <ref name="Polkinghorn" />. | ||
== Technique == | == Technique == | ||
With the patient seated and the elbow flexed, the patient is instructed to lift an object of approximately 2.5 kg. An appropriately weighted sand bag, hand weight, heavy purse or thick book will usually suffice for the purpose of the test<ref name="Polkinghorn" />.<br><br>The test is performed in 2 separate phases | With the patient seated and the elbow flexed, the patient is instructed to lift an object of approximately 2.5 kg. An appropriately weighted sand bag, hand weight, heavy purse or thick book will usually suffice for the purpose of the test<ref name="Polkinghorn" />.<br><br>The test is performed in 2 separate phases: | ||
<br>'''Phase 1: diagnosis of lateral epicondylitis<br>'''The patient grasps the object with the palm facing the floor (pronation of the forearm) and is instructed to attempt to lift it up the object. Pain produced in the elbow, typically in the region of the lateral epicondyle, upon this manoeuvre is suggestive of [[Lateral Epicondylitis]].<br>In the absence of lateral epicondylitis however, the patient usually performs this manoeuvre quite easy and without pain.<br>'''<br>Phase 2: diagnosis of medial epicondylitis<br>'''This phase involves the seated patient, with a flexed elbow. The patient is instructed to grasp the object with the palm up (supination of the forearm) and attempt to lift the object. Elbow pain, usually in the region of the medial epicondyle, produced with this manoeuvre is suggestive of [[Medial Epicondylitis]].<br>In the absence of medial epicondyilits, the patient performs this manoeuvre quite comfortably<ref name="Polkinghorn" />. | |||
{{#ev:youtube|NhfeOJfVvyc|300}}<ref>Physiotutors. Polk's Test | Lateral & Medial Epicondylalgia. Available from: http://www.youtube.com/watch?v=NhfeOJfVvyc</ref> | |||
== Other special tests == | == Other special tests == | ||
As there is a lack of strong evidence supporting the use of Polk's test to differentiate between [[Lateral Epicondylitis|Lateral Epicondylitis]] and [[Medial Epicondylitis|Medial Epicondylitis]], a clinician may wish to perform the following special tests to help confirm their diagnosis; | As there is a lack of strong evidence supporting the use of Polk's test to differentiate between [[Lateral Epicondylitis|Lateral Epicondylitis]] and [[Medial Epicondylitis|Medial Epicondylitis]], a clinician may wish to perform the following special tests to help confirm their diagnosis; | ||
=== Lateral Epicondylitis === | |||
* [[Cozen’s Test|Cozen's test]] | * [[Cozen’s Test|Cozen's test]] | ||
* [[Mill’s Test|Mill's test]] | * [[Mill’s Test|Mill's test]] | ||
* [[Maudsley's test]] | * [[Maudsley's test]] | ||
=== Medial Epicondylitis === | |||
* [[Golfer’s Elbow Test|Medial Epicondylitis test]] (Golfer's elbow test) | * [[Golfer’s Elbow Test|Medial Epicondylitis test]] (Golfer's elbow test) | ||
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<references /> | <references /> | ||
[[Category:Vrije Universiteit Brussel Project | [[Category:Vrije Universiteit Brussel Project]] | ||
[[Category:Elbow]] | |||
[[Category:Elbow - Assessment and Examination]] | |||
[[Category:Special Tests]] | |||
[[Category:Musculoskeletal/Orthopaedics]] | |||
[[Category:Elbow - Special Tests]] | |||
Latest revision as of 12:27, 2 October 2022
Top Contributors - Sanne Delporte, Admin, Oyemi Sillo, Adam Vallely Farrell, Mariam Hashem, Kim Jackson, WikiSysop and Chelsea Mclene
Definition/Description[edit | edit source]
Polk’s test is an easy to learn, easy to perform and simple to interpret test that can help the clinician differentiate between Lateral Epicondylitis and Medial Epicondylitis.
It aids the clinician in establishing a working diagnosis and also serves as an educational tool for the patient in helping them to better understand their condition, and to avoid the specific activities that aggravate the injury[1].
Clinically Relevant Anatomy[edit | edit source]
Wrist extensor group
- M. extensor digitorum
- M. extensor digiti minimi
- M. extensor carpi ulnaris
All these muscles have the same origin: the lateral epicondyle.
Wrist flexor group
- M. pronator teres
- M. flexor digitorum superficialis
- M. flexor carpi radialis
- M. flexor carpi ulnaris
- M. palmaris longus
All these muscles have the same origin: the medial epicondyle.
Purpose[edit | edit source]
The use of Polk’s test may help the clinician to diagnostically differentiate between Lateral Epicondylitis en Medial Epicondylitis, 2 of the most common causes of elbow pain.
Polk’s test also helps to definitively identify the method of lifting that is best to be avoided by the patient [1].
The mechanism of the Polk’s test is very straightforward. When the hand grasps an object, tension is placed on both the flexors and the extensors of the wrist. The motion of lifting an object, aggravates the tension on the primary affected muscle group with resulting mechanical strain at the inflamed musculotendinous attachment site [1].
Technique[edit | edit source]
With the patient seated and the elbow flexed, the patient is instructed to lift an object of approximately 2.5 kg. An appropriately weighted sand bag, hand weight, heavy purse or thick book will usually suffice for the purpose of the test[1].
The test is performed in 2 separate phases:
Phase 1: diagnosis of lateral epicondylitis
The patient grasps the object with the palm facing the floor (pronation of the forearm) and is instructed to attempt to lift it up the object. Pain produced in the elbow, typically in the region of the lateral epicondyle, upon this manoeuvre is suggestive of Lateral Epicondylitis.
In the absence of lateral epicondylitis however, the patient usually performs this manoeuvre quite easy and without pain.
Phase 2: diagnosis of medial epicondylitis
This phase involves the seated patient, with a flexed elbow. The patient is instructed to grasp the object with the palm up (supination of the forearm) and attempt to lift the object. Elbow pain, usually in the region of the medial epicondyle, produced with this manoeuvre is suggestive of Medial Epicondylitis.
In the absence of medial epicondyilits, the patient performs this manoeuvre quite comfortably[1].
Other special tests[edit | edit source]
As there is a lack of strong evidence supporting the use of Polk's test to differentiate between Lateral Epicondylitis and Medial Epicondylitis, a clinician may wish to perform the following special tests to help confirm their diagnosis;
Lateral Epicondylitis[edit | edit source]
Medial Epicondylitis[edit | edit source]
- Medial Epicondylitis test (Golfer's elbow test)
