Elbow Physical Exam

• WIPE, blah blah 🙂
• “Take vital signs”
• Position: anatomical position
• Proper exposure: of both upper limbs
• General inspection of the pt and surroundings (walking aids)

• Look:
  • Front:
    • Carrying angle (15°)
    • Varus\valgus deformities
    • Muscle wasting
  • Sides:
    • Scars
    • Swelling \ cysts
    • Olecranon bursitis
    • Limited \ hyper-extension
  • Back:
    • Rheumatoid nodules
    • Gouty tophi
    • Psoriatic plaques

• Feel: (first ask pt if they have pain?)
  • Temperature
  • Elbow joint: epicondyles, radial head, ulnar olecranon process
    • Comment on tenderness and bony\soft swelling

• Move:
  • Active + passive + against resistance: flexion, extension, pronation, supination

• Special tests:
  • Tennis elbow (lateral epicondylitis): flex elbow 90° + pronate + extend wrist against resistance
  • Golfer’s elbow (medial epicondylitis): passively extend and supinate elbow + extend wrist
  • Valgus\Varus stress test: flex elbow 30°
  • Tinel’s sign (cubital tunnel syndrome): tap ulnar N. near medial epicondyle + ask if there’s pain\tingling in the ulnar N distribution (medial 1 and 1\2 fingers)

• Neurovascular:
  • Pulses
  • Reflexes

• Joint above + joint below

Download the PDF version: here