Elbow Exam

May 30, 2016 Print Friendly Version of this page Print Get a PDF version of this webpage PDF
Introduces self
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Confirms name & age of patient
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Explains & gains consent
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Asks if patient suffers from pain, stiffness or reduced range of movement in the elbow
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Washes hands
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Exposes patient’s elbows and the joints above and below (shoulders and hands) and asks them to stand
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General inspection around bed and patient (walking aids, obvious scars, wasting or deformities)
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Inspects front for shoulder/hip alignment, limb-limb discrepancy, shoulder architecture
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Inspects back for wasting of muscles (trapezius, paraspinal, deltoids), scoliosis, skin changes, scars, winging of scapulae, elbow nodules, deformities
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Inspects sides for fixed flexion deformities, increased kyphosis or lordosis, carrying angle of the elbow
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Palpates temperature of elbow joint
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Palpates elbow structures: lateral and medial epicondyles, olecranon process and fossa, radial head and joint line feeling for tenderness. Also feels for tophi, tenderness and effusions
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Tests active flexion and flexes further passively if range of movement is restricted. Comments on maximum angle (normal: 145 degrees). In the same way tests extension, supination and pronation at the elbow
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Feels shoulder when moving arm in all planes for crepitus, pain or limitation of movement
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Offers examination of shoulder and hand, neurovascular exam and history
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Thanks patient and offers help to redress
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Washes hands
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Offers next step (imaging: 2 plain x rays for bony pathology or CT if indicated, MRI for soft tissue)
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Summarises appropriately with only key findings
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Offers appropriate differential diagnoses
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