Elbow Examination
Foreword
Elbow complaints are often related to pain, such as epicondylitis (tennis and golfer’s elbow), fractures, and bursitis. Complaints can also be skin related with regards to other medical conditions, such as psoriasis and rheumatoid arthritis. Occasionally elbow problems can also cause ulnar nerve entrapment.
The elbow examination, along with all other joint examinations, is commonly tested on in OSCEs. You should ensure you are able to perform this confidently.
The examination of all joints follows the general pattern of “look, feel, move” and occasionally some special tests.
Procedure Steps
Step 01
Wash your hands and introduce yourself to the patient. Clarify the patient’s identity and explain what you would like to examine, gain their consent.
Ensure the elbows are appropriately exposed, in this case the patient will probably be wearing a t-shirt.
Step 02
Begin with observation of the joint. Inspect:
- The front to check the carrying angle.
- From the side to check for a fixed flexion deformity.
- From behind and on the inside to check for scars, swellings, rashes, rheumatoid nodules and psoriatic plaques.
Step 03
Feel the elbow, assessing the joint temperature relative to the rest of the arm.
Step 04
Palpate the olecranon process as well as the lateral and medial epicondyles for tenderness.
Step 05
The movements at the elbow joint are all fairly easy to describe and assess, which are:
- Flexion
- Extension
- Pronation
- Supination
Once these have been assessed actively they should be checked passively feeling for crepitus.
Step 06
Finally check for tennis elbow and golfer’s elbow. Check each of these individually to eliminate them.
Tennis elbow localises pain over the lateral epicondyle, particularly on active extension of the wrist with the elbow bent.
Golfer’s elbow pain localises over the medial epicondyle and is made worse by flexing the wrist.
Step 07
On completion, thank the patient for their time and wash your hands. Report your findings to the examiner.
