Elbow extension sign: Difference between revisions

No edit summary
No edit summary
Line 1: Line 1:
<div class="editorbox">
<div class="editorbox">
'''Original Editor '''- Your name will be added here if you created the original content for this page.
'''Original Editor '''- [[User:Nikki Arnold|Nikki Arnold]]


'''Lead Editors''' - Your name will be added here if you are a lead editor on this page.&nbsp; [[Physiopedia:Editors|Read more.]]  
'''Lead Editors''' - Your name will be added here if you are a lead editor on this page.&nbsp; [[Physiopedia:Editors|Read more.]]  
</div>  
</div>  
== Purpose<br> ==
== Purpose<br> ==


To test the presence of either a bony fracture or for elbow joint effusion.<ref name="Hawksworth and Freeland">Hawksworth CRE, Freeland P. Inability to fully extend teh injured elbow: and indictor for significant injury? Arch of Emerg Med. 1991;8:253-256.</ref>&nbsp;<ref name="Docherty et al">Docherty MA, Schwab RA, Ma,JO. Can elbow extension be used as a test of clinically significant injury?Southern Med J.2002 May;95(5):539-541.</ref><br>
To test the presence of either a bony fracture or for elbow joint effusion.<ref name="Hawksworth and Freeland">Hawksworth CRE, Freeland P. Inability to fully extend teh injured elbow: and indictor for significant injury? Arch of Emerg Med. 1991;8:253-256.</ref>&nbsp;<ref name="Docherty et al">Docherty MA, Schwab RA, Ma,JO. Can elbow extension be used as a test of clinically significant injury?Southern Med J.2002 May;95(5):539-541.</ref><br>  


== Technique<br> ==
== Technique<br> ==


The patient extends elbow as far as possible while either supine or in a standing position.&nbsp; The examiner will assess to whether the patient achieves full extension.  
The patient extends elbow as far as possible while either supine or in a standing position.&nbsp; The examiner will assess to whether the patient achieves full extension.  


A positive test is if the patient is unable to fully extend the elbow.<ref name="Users's guide">Flynn TW, Cleland JA, Whitman JM. Users' guide to the musculoskeletal examination. United States; Evidence in motion:2008.</ref>
A positive test is if the patient is unable to fully extend the elbow.<ref name="Users's guide">Flynn TW, Cleland JA, Whitman JM. Users' guide to the musculoskeletal examination. United States; Evidence in motion:2008.</ref>  


== Evidence  ==
== Evidence  ==


&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; '''Elbow extension test characteristics'''<ref name="Appelboam et al">Appelboam A, Reuben AD, Benger JR, Beech F, Dutson J, Haig S, Higinson I, Klein JA, Le Roux S, Saranga SSM, Taylor R, Vicery J, Powell RJ, Lloyd G. Elbow extension test to rule out elbow fracture: multicentre prospective validation and observational study of diagnostic accuracy in adults and children. BMJ.2008;337;a2428.</ref>
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; '''Elbow extension test characteristics'''<ref name="Appelboam et al">Appelboam A, Reuben AD, Benger JR, Beech F, Dutson J, Haig S, Higinson I, Klein JA, Le Roux S, Saranga SSM, Taylor R, Vicery J, Powell RJ, Lloyd G. Elbow extension test to rule out elbow fracture: multicentre prospective validation and observational study of diagnostic accuracy in adults and children. BMJ.2008;337;a2428.</ref>  


&nbsp;&nbsp;''&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;'''Adults'''&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; '''Children'''&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;'''''<i>Combined</i>'''&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;  
&nbsp;&nbsp;''&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;'''Adults'''&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; '''Children'''&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;'''''<i>Combined</i>'''&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;  


''&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Fx&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Fx+effusion&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Fx&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Fx+effusion&nbsp;&nbsp;&nbsp; Fx&nbsp;&nbsp;&nbsp;&nbsp; Fx+effusion&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;''
''&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Fx&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Fx+effusion&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Fx&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Fx+effusion&nbsp;&nbsp;&nbsp; Fx&nbsp;&nbsp;&nbsp;&nbsp; Fx+effusion&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;''  


''Sensitivity&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ''98.4&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 97.3&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 94.6&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 93.7&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 96.8&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 95.8
''Sensitivity&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ''98.4&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 97.3&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 94.6&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 93.7&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 96.8&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 95.8  


''Specificity&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ''47.7&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 54.3&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 49.5&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 54.8&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 48.5&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 54.6
''Specificity&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ''47.7&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 54.3&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 49.5&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 54.8&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 48.5&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 54.6  


''+LR''&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;1.88&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 2.13&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;1.87&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;2.07&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 1.88&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;2.11
''+LR''&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;1.88&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 2.13&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;1.87&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;2.07&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 1.88&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;2.11  


''-LR''&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 0.03&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 0.05&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 0.11&nbsp;&nbsp;&nbsp;&nbsp; 0.11&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 0.06&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;0.08
''-LR''&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 0.03&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 0.05&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 0.11&nbsp;&nbsp;&nbsp;&nbsp; 0.11&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 0.06&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;0.08  


== Resources  ==
== Resources  ==
Line 36: Line 36:
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
<div class="researchbox">
<div class="researchbox">
<rss>Feed goes here!!|charset=UTF-8|short|max=10</rss>  
<rss>http://eutils.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1-ajL1qsWMINAym_nocVuhIPmlW7yzLPSc2_c4TSp3TZ3fCMZ4|charset=UTF-8|short|max=10</rss>  
</div>  
</div>  
== References  ==
== References  ==
Line 43: Line 43:


<references />
<references />
[[Category:Articles]] [[Category:Assessment]] [[Category:Elbow]] [[Category:EIM Student Project 2]] [[Category:Musculoskeletal/Orthopaedics]]  [[Category:Special Tests]]

Revision as of 19:49, 8 December 2009

Original Editor - Nikki Arnold

Lead Editors - Your name will be added here if you are a lead editor on this page.  Read more.

Purpose
[edit | edit source]

To test the presence of either a bony fracture or for elbow joint effusion.[1] [2]

Technique
[edit | edit source]

The patient extends elbow as far as possible while either supine or in a standing position.  The examiner will assess to whether the patient achieves full extension.

A positive test is if the patient is unable to fully extend the elbow.[3]

Evidence[edit | edit source]

                  Elbow extension test characteristics[4]

                               Adults                   Children            Combined                                                                             

                       Fx        Fx+effusion     Fx     Fx+effusion    Fx     Fx+effusion         

Sensitivity      98.4             97.3          94.6      93.7          96.8       95.8

Specificity      47.7             54.3          49.5      54.8          48.5       54.6

+LR               1.88             2.13          1.87      2.07          1.88       2.11

-LR                 0.03            0.05           0.11     0.11           0.06      0.08

Resources[edit | edit source]

add any relevant resources here

Recent Related Research (from Pubmed)[edit | edit source]

Failed to load RSS feed from http://eutils.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1-ajL1qsWMINAym_nocVuhIPmlW7yzLPSc2_c4TSp3TZ3fCMZ4|charset=UTF-8|short|max=10: Error parsing XML for RSS

References[edit | edit source]

References will automatically be added here, see adding references tutorial.

  1. ↑ Hawksworth CRE, Freeland P. Inability to fully extend teh injured elbow: and indictor for significant injury? Arch of Emerg Med. 1991;8:253-256.
  2. ↑ Docherty MA, Schwab RA, Ma,JO. Can elbow extension be used as a test of clinically significant injury?Southern Med J.2002 May;95(5):539-541.
  3. ↑ Flynn TW, Cleland JA, Whitman JM. Users' guide to the musculoskeletal examination. United States; Evidence in motion:2008.
  4. ↑ Appelboam A, Reuben AD, Benger JR, Beech F, Dutson J, Haig S, Higinson I, Klein JA, Le Roux S, Saranga SSM, Taylor R, Vicery J, Powell RJ, Lloyd G. Elbow extension test to rule out elbow fracture: multicentre prospective validation and observational study of diagnostic accuracy in adults and children. BMJ.2008;337;a2428.
Retrieved from "https://www.physio-pedia.com/index.php?title=Elbow_extension_sign&oldid=10064"