Elbow Plica Impingement Test

Original Editor - Anas Mohamed Top Contributors - Anas Mohamed and Rucha Gadgil

Purpose[edit | edit source]

Elbow Plica Impingement Test is used to determine the plica syndrome or synovial fold syndrome in the elbow.

Technique[edit | edit source]

Posterolateral radiocapitellar plica test[edit | edit source]

Step 1. Patient position in standing or sitting.

Step 2. Patient elbow in extended and forearm pronated position.

Step 3. Examiner places his thump and applies manual force to the posterolateral aspect of the radiocapitellar joint while passively flexing elbow.

Step 4. Tenderness at the radiocapitellar joint at low flexion angle is markedly diminished at more than 90 degree of flexion with maintaining manual compression force is marked as positive test.[1]

Flexion-Pronation plica test[edit | edit source]

Step 1. Patient position in standing or sitting.

Step 2. Patient elbow in extended and forearm pronated position.

Step 3. Examiner applies lateral load to the elbow while passively flexing elbow.

Step 4. Snapping above between 90 and 110 degree of flexion indicates positive test.[2]

Evidence[edit | edit source]

For Posterolateral radiocapitellar plica test the research was done on 24 patients, out of 24 patients 20 of them tested positive.[1][3]

See the test diagnostics page for an explanation of statistics.
Sensitivity - 83.3%[1]
Specificity - 87.5%[1]
Positive predictive value -74.1%[1]
Negative predictive value - 92.5%[1]
Accuracy value - 86.3%[1]

For the Flexion-Pronation plica test research was done on 14 patients only 7 (50%) of them tested positive.[2][3]

References[edit | edit source]

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Park KB, Kim SJ, Chun YM, Yoon TH, Choi YS, Jung M. Clinical and diagnostic outcomes in arthroscopic treatment for posterolateral plicae impingement within the radiocapitellar joint. Medicine (Baltimore). 2019 May;98(18):e15497. doi: 10.1097/MD.0000000000015497. PMID: 31045835; PMCID: PMC6504535.
  2. 2.0 2.1 Antuna SA, O'Driscoll SW. Snapping plicae associated with radiocapitellar chondromalacia. Arthroscopy. 2001 May;17(5):491-5. doi: 10.1053/jars.2001.20096. PMID: 11337715.
  3. 3.0 3.1 Lubiatowski P, Wałecka J, Dzianach M, Stefaniak J, Romanowski L. Synovial plica of the elbow and its clinical relevance. EFORT Open Rev. 2020 Sep 30;5(9):549-557. doi: 10.1302/2058-5241.5.200027. PMID: 33072407; PMCID: PMC7528666.