elbow + forearm pathologies

Question 2

What is lateral epicondylopathy commonly known as?

Answer 2

Tennis elbow

Question 3

What causes lateral epicondylopathy?

Answer 3

Repetitive strain on the extensor muscles, especially the extensor carpi radialis brevis (ECRB)

Question 4

What leads to pain and weakened grip in lateral epicondylopathy?

Answer 4

Tendon degeneration rather than inflammation

Question 5

What happens to collagen fibers in tendinopathy?

Answer 5

They become disorganized and fragmented

Question 6

What type of collagen increases in tendinopathy?

Answer 6

Type III collagen

Question 7

What is the role of tenocytes in tendinopathy?

Answer 7

They proliferate and produce enzymes that break down the extracellular matrix

Question 8

What accumulates in the matrix during tendinopathy?

Answer 8

Glycosaminoglycans (GAGs), especially proteoglycans

Question 9

What is neovascularization?

Answer 9

The process where new blood vessels and nerve fibers penetrate the tendon

Question 10

What is the significance of the absence of classic inflammatory cells in tendinopathy?

Answer 10

It indicates a chronic degenerative process, sometimes referred to as ‘failed healing’

Question 11

What are common signs and symptoms of lateral epicondalopathy?

Answer 11

Pain over the lateral epicondyle, tenderness, decreased grip strength, pain radiating down the forearm

Question 12

Name the four sites of lateral epicondalopathy.

Answer 12

• Extensor carpi radialis brevis (ECRB) origin
• Extensor digitorum communis
• Lateral epicondyle
• Surrounding musculature of the forearm

Question 13

What conditions can mimic lateral epicondalopathy?

Answer 13

• Radial tunnel syndrome
• Cervical radiculopathy (C6-7)
• Intra-articular elbow pathologies

Question 14

Which populations are commonly affected by lateral epicondalopathy?

Answer 14

Individuals engaged in repetitive arm activities, such as athletes, laborers, and office workers

Question 15

What is a key treatment option for lateral epicondalopathy?

Answer 15

Exercise therapy, especially eccentric strengthening exercises for the extensors

Question 16

What are some non-physiotherapy treatments for lateral epicondalopathy?

Answer 16

• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Corticosteroid injections
• Platelet-rich plasma (PRP) injections
• Surgery in chronic cases

Question 17

What is the primary difference between medial and lateral epicondalopathy?

Answer 17

Medial epicondylopathy affects the flexor-pronator muscles, while lateral epicondylopathy involves the extensor tendons

Question 18

What are the signs and symptoms of biceps tendinopathy?

Answer 18

Pain in the anterior elbow, worsening with resisted elbow flexion or supination

Question 19

Where do patients typically experience pain in biceps tendinopathy?

Answer 19

At the biceps tendon near its attachment on the radial tuberosity

Question 20

What elbow movements would recreate a patient’s pain in biceps tendinopathy?

Answer 20

Elbow flexion and forearm supination

Question 21

Which ligaments primarily stabilize the elbow?

Answer 21

• lateral/ Radial collateral ligament
• medial/ ulnar collateral ligament
• Annular ligament

Question 22

How can elbow ligaments be injured?

Answer 22

By trauma, such as elbow dislocation, or repetitive stress in throwing sports

Question 23

What methods are used to diagnose ligament injuries?

Answer 23

• Clinical tests (e.g., varus stress test)
• Imaging (MRI or ultrasound)
• Functional assessment

Question 24

What is a common cause of a stiff elbow?

Answer 24

Trauma, arthritis, immobilization, or contracture

Question 25

What are signs of loose bodies causing a stiff elbow?

Answer 25

* Locking * Clicking * Sudden pain * Limited range of motion

Question 26

How is symptomatic loose bodies in the elbow managed?

Answer 26

Typically managed with arthroscopic removal

Question 27

How can you differentiate between OA and RA in the elbow joint?

Answer 27

OA presents with pain and stiffness related to use, while RA has systemic signs, morning stiffness, and possible bilateral involvement

Question 28

What is the management for osteoarthritis (OA) in the elbow?

Answer 28

* Pain management * Physiotherapy * Surgery in advanced cases

Question 29

What is olecranon bursitis?

Answer 29

Inflammation of the bursa located over the olecranon process

Question 30

What are indications for diagnosing olecranon bursitis?

Answer 30

* Swelling over the olecranon * Tenderness * Redness or warmth if infected

Question 31

How can you differentiate between infective and non-infective olecranon bursitis?

Answer 31

Infective bursitis may present with systemic signs, warmth, and purulent discharge; non-infective cases are usually just swollen and painful

Question 32

What is the management for olecranon bursitis?

Answer 32

* Rest * Ice * Compression * NSAIDs * Drainage if necessary

Question 33

What is the common cause of radial head subluxation in young children?

Answer 33

A sudden pull on an extended arm (e.g., 'nursemaid’s elbow')

Question 34

What are the signs of radial head subluxation in children?

Answer 34

The child may hold the arm slightly flexed and pronated, refusing to use it

Question 35

What is the management for radial head subluxation?

Answer 35

Reduction maneuver, often performed in A&E

Question 36

What should you be mindful of with children presenting with radial head subluxation?

Answer 36

Ensure there are no signs of physical abuse

Question 37

What is osteochondritis dissecans?

Answer 37

A condition characterized by small areas of bone and cartilage detaching from the joint surface

Question 38

What age group is typically affected by osteochondritis dissecans?

Answer 38

Adolescents involved in repetitive overhead or throwing sports