Elbow Special Tests

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Author:
ae_228
ID:
283898
Filename:
Elbow Special Tests
Updated:
2014-09-23 12:49:27
Tags:
Elbow Special Tests Upper Extremity
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Description:
Special tests of the elbow
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  1. Capsular Injury Test
    • P: sitting/standing elbow fully extended
    • E: Observing
    • Pr: Instruct Athlete to fully flex and extend the wrist
    • +: pain; bilaterally
    • I: anterior or posterior capsule injury
    • *rather worthless, lots of false positives, but good starting point
  2. Valgus Stress Test of the Elbow
    • P: sit/stand, elbow at 90, forearm in neutral
    • E: lateral to affected side, one hand on lateral joint line, other hand on distal forearm
    • Pr: Apply a valgus force in multiple degrees from 0-90
    • +: pain/laxity; bilaterally
    • I: rupture of UCL
  3. Moving Valgus Stress Test
    • P: sit/stand, shoulder abducted to 90, elbow fully flexed
    • E: lateral to affected side, one hand on lateral joint line, other on distal forearm
    • Pr: while applying a valgus force and external rotation, passively extend the elbow to 30 of flexion and then return to starting position
    • +: pain/laxity; bilaterally
    • I: rupture of the UCL
  4. Varus Stress Test of the Elbow
    • P: sit/stand, elbow at 90, forearm in neutral
    • E: medial to affected side, one hand on medial joint line with fingers palpating the lateral joint line, the other hand on distal forearm
    • Pr: Apply a varus force in multiple degrees of flexion from 0-90
    • +: pain/laxity; bilaterally
    • I: rupture of RCL
  5. Medial Epicondylitis
    • P: sit/stand
    • E: lateral to affected side palpating the flexor muscles at the origin
    • Pr: 1. instruct the athlete to actively extend the wrist and then the elbow as you palpate. 2. Examiners other hand will be placed on the anterior side of the hand. Instruct the athlete to flex the wrist against resistance as you palpate
    • +: pain/weakness; bilaterally
    • I: medial epicondylitis
  6. Mill's Test
    • P: sit/stand, elbow flexed to 90 (easier in neutral)
    • E: lateral to affected side, one hand palpating the extensor tendons
    • Pr: Instruct the athlete to make a fist, flex the wrist and then extend the elbow
    • +: pain; bilaterally
    • I: lateral epicondylitis
  7. Cozen's Test
    • P: sit/stand, elbow flexed to 90 (same as Mill's)
    • E: lateral to affected side, one hand palpating extensor tendons, the other on dorsal side of hand
    • Pr: instruct athlete to extend the wrist against resistance as you palpate the extensor tendons
    • +: pain/weakness; bilaterally
    • I: Lateral epicondylitis
  8. Pronator  Teres Syndrome Test
    • P: sit/stand, elbow flexed to 90, forearm in neutral
    • E: in front of athlete, one hand supporting the forearm, the other hand grasping the hand in a handshake
    • Pr: instruct the athlete to pronate the forearm against resistance
    • +: pain/weakness; bilaterally
    • I: Pronator teres syndrome
  9. Pinch grip test
    • P: sit/stand
    • E: observing
    • Pr: Instruct the athlete to pinch their thumb and index finger together
    • +: inability to touch the thumb and finger; bilaterally
    • I: entrapment of the anterior interosseous nerve between the 2 heads of the pronator muscles
  10. Tinel's Sign
    • P: sit/stand, elbow is slightly flexed
    • E: on affected side, one hand supporting the forearm
    • Pr: tap over ulnar nerve within the ulnar groove with the tip of the finger or reflex hammer
    • +: pain, parasthesia, radiating pain; bilaterally
    • I: damage to ulnar nerve
  11. Posterolateral Instability Test
    • P: laying supine, shoulder flexed to 90, elbow flexed to 90, forearm fully pronated
    • E: standing lateral to affected side, one hand at the lateral proximal forearm, other grasping distal forearm
    • Pr: apply an axial load to the forearm and a valgus force to the elbow. The elbow is then extended and the shoulder felxed, then return to starting position
    • +: the elbow will sublux while in extension and relocate when moved back to the starting point; bilaterally (also look for apprehension)
    • I: chronic instability of the elbow

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