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Foundations III-Musculoskeletal/Rheum > Elbow > Flashcards

Flashcards in Elbow Deck (37)
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1

What is lateral epicondylitis?

"tennis elbow"

Overuse inflammatory injury involving common extensor tendon

Repetitive wrist or combined wrist and finger extension.

2

PE findings in lateral epicondylitis?

Significant pain and 3/5 strength with resisted 3rd digit extension.

3

Tendonitis v. tendonosis?

both are tendon overuse injuries

itis: Inflammation, fiber disruption/ degeneration

osis: Mucoid degeneration, Sporadic inflammation
Inflammatory process “stalled”, fiber disorganization

4

Tx of tendonitis?

Steroid injection

Activity modification

NSAIDs

Ice

Therapeutic exercise
(Stretching
Strengthening)

+/- Bracing, PT

5

Tx of tendonosis?

Activity modification

PT, exercise

+/- Bracing

NSAIDs & Steroid injection = NOT beneficial long term

6

Fundamentals of tendonosis tx?

Mod aggravating activity

correct biomechanical
faults

address degenerative component

exercise

7

What can be used to help tendonosis-address degenerative component

ASTYM

Graston

Dry Needling

PRP injections

8

Who is usually affected by distal biceps tendon tear?

Men > 40 years of age with preexisting degenerative changes in biceps tendon

9

MOA of distal biceps tendon tear?

Rapid eccentric contraction of biceps leads to distal tendon tear at radial insertion

10

Non surg tx for partial distal biceps tendon tear?

Bracing with ROM limitation X 4 weeks
Gradual progression of ROM and strengthening

11

Non surg tx for complete distal biceps tendon tear?

Older patients with sedentary lifestyle who are willing to accept strength loss

12

Surgical tx for distal biceps tendon tear?

Complete tendon rupture in young active individuals (quick surg consult is imperative for best outcomes)

Elective for partial tears in young active individuals

13

"hurts when I throw a baseball" + mild swelling in region of medial epicondyle and focal tenderness over medial joint line, medial epicondyle and adjacent portion of the common flexor tendon

Medial epicondylitis/osis

v.

ulnar collateral ligament tear

v.

Medial epicondyle apophysitis “Little leaguer's elbow”

14

what tests can you use to test ulnar collateral ligament?

Valgus stress test

Milk maneuver**

moving valgus stress test ***

15

How is the milking maneuver performed?

Tests posterior band of UCL

Assess for pain, medial joint laxity, and end feel

16

How is the moving valgus stress test performed?

Pain throughout ROM = UCL insufficiency

Good s/s

Shear angle 120° to 80°

17

Tx for medial epicondylitis/osis?

similar to lateral epicondylitis/osis

18

Tx for ulnar collateral ligament tear

surg consult

19

Tx for Medial epicondyle apophysitis “Little leaguer's elbow”?

Activity modification: no throwing 6-8 wks

PT

Gradual return to throwing

20

" I have a golf ball hanging off my elbow"

olecranon bursitis

due to repetitive trauma to elbow (i.e. typing with elbow on armrest)

21

Presentation of non-inflammatory bursitis?

As a result of repeated trauma (e.g. persistent leaning on elbows), excess fluid can develop within the bursa, causing it to become very apparent on direct observation.

22

PE findings seen in non-inflammatory bursitis?

Obvious swelling at the tip of the elbow

no pain, redness or warmth

Full, painless ROM of the elbow.

23

What causes inflammatory bursitis?

Result of infection or any other intense inflammatory process

24

PE findings seen in inflammatory bursitis?

Obvious swelling at the tip of the elbow

(+) warmth, redness, and pain on palpation of the bursa.

+/- limitation of elbow flexion

25

Tx for olecranon bursitis?

if small/mild: activity mod + NSAIDS

elbow pad

avoid hyperflexion against hard surfaces

if large/concern for infx: aspiration

26

How do you perform an olecranon bursa aspiration?

27 G needle over lateral aspect of bursa, aspirate contents until bursa is flat

if concern for infx: culture, NO steroids

if no infx: steroids

27

What causes elbow dislocations?

High energy injuries

Most common joint dislocation in children


28

What must be ruled out when concerned for elbow dislocation?

olecranon or radial head fracture

Coronoid process fractures are commonly seen in posterior dislocations

29

What component is critical for elbow dislocation?

NV exam

30

What is a nursemaid's elbow?

subluxation of the annular ligament