What are the findings of an elbow examination?

From the Guidelines

The findings of an elbow examination typically include pain, swelling, restricted range of motion, stiffness, and numbness or tingling.

Common Causes of Elbow Pain

• Epicondylalgia: caused by tendinosis of the common extensor tendon laterally (“tennis elbow”) or the common flexor tendon medially (“golfer’s elbow”) 1
• Biceps tendinopathy: inflammation of the biceps tendon
• Osteochondral injuries: damage to the cartilage and bone in the elbow joint
• Collateral ligament tears: tears in the ligaments that connect the bones in the elbow joint
• Cubital tunnel syndrome: compression of the ulnar nerve in the elbow

Diagnostic Imaging

• Radiographs: initial imaging for chronic elbow pain, may show intra-articular bodies, heterotopic ossification, osteochondral lesion, soft tissue calcification, occult fracture, or osteoarthritis 1
• MRI: may be used to evaluate suspected tendon, ligament, or muscle injury, or to assess for intra-articular pathology such as osteocartilaginous body, osteochondral lesion, or synovial abnormality 1
• US: may be used to evaluate the distal biceps tendon, triceps tendon, and medial and lateral elbow structures, with moderate agreement with MRI for the diagnosis and grading of common extensor tendon tears 1

Clinical Examination

• Comparison with the contralateral elbow: may be helpful to look for asymmetry 1
• Stress testing: may be used to evaluate joint stability and detect ligamentous injuries 1
• Sonoelastography: may be used to detect medial epicondylalgia with high sensitivity and specificity 1

From the Research

Elbow Examination Findings

The findings of an elbow examination can be comprehensive and critical in formulating an accurate diagnosis 2. A thorough physical examination of the elbow can provide reproducible results and contribute to the determination of a correct diagnosis in a majority of presenting patients 3.

Key Components of Elbow Examination

• A comprehensive approach to the physical examination of the elbow, including special tests, may facilitate improved diagnosis of elbow pathology 2
• Knowledge of the anatomy and physiology of the elbow joint is critical for conducting a focused physical examination and arriving at an accurate diagnosis 4
• The examination should include assessment of range of motion, strength, and pain, as well as the use of provocative maneuvers 5
• A detailed knowledge of elbow anatomy and pathomechanics is essential for conducting a directed history and physical examination that achieves an accurate diagnosis 6

Examination Techniques

• Special physical examinations and tests can improve the clinician's ability to establish an accurate diagnosis 2
• A systematic approach to the physical examination of the elbow, based on medial, lateral, anterior, and posterior aspects, can help to identify potential pathology 4
• The use of hand-held dynamometry to assess strength and patient self-report instruments, such as the Patient-rated Elbow Evaluation, can provide valuable information about elbow function and disability 5