Elbow Examination: Difference between revisions
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'''Subjective History'''<br>• Exact location of pain<br>• Timeline-When are the patients reported symptoms at their worst?<br>• Mechanism of the injury- In the case of a traumatic event, the mechanism of injury helps guide the diagnosis.<sup>1</sup> For atraumatic injuries, specific symptoms can be highly useful in determining a diagnosis.<br> For example: patient reported numbness and/or tingling in the 5th digit may suggest ulnar neuropathy.<sup>1</sup><br>• Presence of numbness or tingling?<br>• Medications?<br>• Past Medical History<br>• Diagnostic Testing/Imaging?<br> | '''Subjective History'''<br>• Exact location of pain<br>• Timeline-When are the patients reported symptoms at their worst?<br>• Mechanism of the injury- In the case of a traumatic event, the mechanism of injury helps guide the diagnosis.<sup>1</sup> For atraumatic injuries, specific symptoms can be highly useful in determining a diagnosis.<br> For example: patient reported numbness and/or tingling in the 5th digit may suggest ulnar neuropathy.<sup>1</sup><br>• Presence of numbness or tingling?<br>• Medications?<br>• Past Medical History<br>• Diagnostic Testing/Imaging?<br> | ||
• '''Region Specific Historical Question: These questions will help guide the examination. For example:<sup></sup>'''<sup>5</sup><br>1. ''Do your symptoms change (better or worse) with any movements of the neck or shoulder?''<br>“Yes” the cervical spine and shoulder region should be screened.<br>''2. Does your elbow ever “slip out” or feel unstable?''<br>“Yes”, elbow instability could be indicated<br>''3. Does the pain change with gripping activities?''<br>“Yes” could indicate possible lateral or medial epicondylagia.<br>''4. Do you ever experience numbness of tingling in the hand?''<br>“Yes” could indicate possible pronator teres or cubital tunnel syndrome.<br>''5. Was the elbow hyper extended during the time of injury?''<br>“Yes” could indicate fracture of ligamentous/capsular damage.<br>''6. Do you relate the symptoms to a throwing activity?''<br>“Yes” could indicate medial instability | • '''Region Specific Historical Question: These questions will help guide the examination. For example:<sup></sup>'''<sup>5</sup><br>1. ''Do your symptoms change (better or worse) with any movements of the neck or shoulder?''<br> “Yes” the cervical spine and shoulder region should be screened.<br>''2. Does your elbow ever “slip out” or feel unstable?''<br> “Yes”, elbow instability could be indicated<br>''3. Does the pain change with gripping activities?''<br> “Yes” could indicate possible lateral or medial epicondylagia.<br>''4. Do you ever experience numbness of tingling in the hand?''<br> “Yes” could indicate possible pronator teres or cubital tunnel syndrome.<br>''5. Was the elbow hyper extended during the time of injury?''<br> “Yes” could indicate fracture of ligamentous/capsular damage.<br>''6. Do you relate the symptoms to a throwing activity?''<br> “Yes” could indicate medial instability. | ||
'''• Environmental and Personal Factors'''<br>During the initial examination, environmental and personal factors should be addressed. These issues could affect healing and return of function after an elbow injury.<sup>1</sup> Table 1 outlines these issues. | |||
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Revision as of 21:40, 19 March 2011
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Subjective[edit | edit source]
Clinical Presentation
Pain and symptoms localized in or around elbow. May present with neurological symptoms local or distant to elbow.
Subjective History
• Exact location of pain
• Timeline-When are the patients reported symptoms at their worst?
• Mechanism of the injury- In the case of a traumatic event, the mechanism of injury helps guide the diagnosis.1 For atraumatic injuries, specific symptoms can be highly useful in determining a diagnosis.
For example: patient reported numbness and/or tingling in the 5th digit may suggest ulnar neuropathy.1
• Presence of numbness or tingling?
• Medications?
• Past Medical History
• Diagnostic Testing/Imaging?
• Region Specific Historical Question: These questions will help guide the examination. For example:5
1. Do your symptoms change (better or worse) with any movements of the neck or shoulder?
“Yes” the cervical spine and shoulder region should be screened.
2. Does your elbow ever “slip out” or feel unstable?
“Yes”, elbow instability could be indicated
3. Does the pain change with gripping activities?
“Yes” could indicate possible lateral or medial epicondylagia.
4. Do you ever experience numbness of tingling in the hand?
“Yes” could indicate possible pronator teres or cubital tunnel syndrome.
5. Was the elbow hyper extended during the time of injury?
“Yes” could indicate fracture of ligamentous/capsular damage.
6. Do you relate the symptoms to a throwing activity?
“Yes” could indicate medial instability.
• Environmental and Personal Factors
During the initial examination, environmental and personal factors should be addressed. These issues could affect healing and return of function after an elbow injury.1 Table 1 outlines these issues.
Objective[edit | edit source]
Observation[edit | edit source]
- Posture
- Movement Patterns
Functional Tests
[edit | edit source]
Palpation[edit | edit source]
- supine
- prone
- seated
Neurologic Assessment
[edit | edit source]
Movement Testing[edit | edit source]
- AROM, PROM, and Overpressure
- Passive Intervertebral Motion
- Muscle Strength
Special Tests[edit | edit source]
References[edit | edit source]
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