Elbow Pathologies

Question 1

Tennis elbow (lateral epicondylitis) - SUBJECTIVE

Answer 1

○ Lateral elbow pain, worsens with gripping or wrist extension (e.g., lifting a kettle)
○ Gradual onset, often overuse-related

Question 2

Tennis elbow (lateral epicondylitis) - OBJECTIVE

Answer 2

○ Tenderness/pain over lateral epicondyle
○ Pain with resisted wrist extension or resisted middle finger extension
○ Pain on passive wrist flexion with elbow extended
○ ROM usually preserved, but painful at end range

Question 3

Tennis elbow (lateral epicondylitis) - Differential diagnosis

Answer 3

○ Posterior interosseous nerve syndrome: pain and weakness in thumb & finger extension
○ RA, OA

Question 4

Golfers elbow (medial epicondylitis) - SUBJECTIVE

Answer 4

○ Medial elbow pain, aggravated by wrist flexion or forearm pronation
○ Often activity-related (e.g., golf, throwing)
○ Overuse , tendon over-load injury

Question 5

Golfers elbow (medial epicondylitis) - OBJECTIVE

Answer 5

○ Tenderness over medial epicondyle
○ Pain with resisted wrist flexion and forearm pronation
○ Pain on passive wrist extension
○ ROM preserved, but may be limited by pain

Question 6

Golfers elbow (medial epicondylitis) - Differential diagnosis

Answer 6

○ Medial structures
○ Subluxation of the ulnar nerve
○ Snapping triceps
○ Thrower’s elbow

Question 7

Distal Biceps Tendon Injury (Tendinosis or Rupture) - SUBJECTIVE

Answer 7

○ Sudden sharp pain in anterior elbow (rupture) or chronic ache (tendinosis)
○ Weakness with lifting or supination
○ PMH of steroid use (more common with steroids)
○ MOI?

Question 8

Distal Biceps Tendon Injury (Tendinosis or Rupture) - OBJECTIVE

Answer 8

○ Rupture: Visible bulge in upper arm (“Popeye sign”), bruising, weakness in elbow flexion and supination
○ Tendinosis: Tenderness in distal biceps area
○ Pain/weakness with resisted supination and elbow flexion
○ Hook test

Question 9

Arthropathy (OA, RA, Gout) - SUBJECTIVE

Answer 9

○ Joint pain, stiffness, swelling
○ OA: Gradual onset, worse with activity
○ RA: Morning stiffness > 30 mins, symmetrical involvement
○ Gout: Sudden, severe pain and swelling, often at night

Question 10

Arthropathy (OA, RA, Gout) - OBJECTIVE

Answer 10

○ OA: Bony enlargement, crepitus, ↓ active and passive ROM
○ RA: Warm, swollen joint, ↓ ROM, possible nodules, systemic signs
○ Gout: Red, hot, extremely tender joint, tophi (chronic), ↓ ROM

Question 11

Traumatic Injuries (Fractures/Dislocations) - SUBJECTIVE

Answer 11

○ History of trauma, acute pain, swelling, inability to move arm

Question 12

Traumatic Injuries (Fractures/Dislocations) - OBJECTIVE

Answer 12

○ Deformity, bruising, swelling
○ Limited or absent ROM (active and passive)
○ Pain on palpation and movement
○ Neurological or vascular compromise in severe cases
○ X-ray confirms diagnosis

Question 13

Olecranon Bursitis - SUBJECTIVE

Answer 13

○ Swelling over tip of elbow, may or may not be painful
○ Possible history of trauma, repetitive pressure (leaning), or infection

Question 14

Olecranon Bursitis - OBJECTIVE

Answer 14

○ Soft, fluctuant swelling over olecranon
○ Erythema and warmth if infected
○ Full ROM usually maintained but may be painful at end range of flexion
○ Non-infectious cases: No systemic signs; infected: fever, malaise