Elbow Exam

Introduces self	0	1
Confirms name & age of patient	0	1
Explains & gains consent	0	1
Asks if patient suffers from pain, stiffness or reduced range of movement in the elbow	0	1
Washes hands	0	1
Exposes patient’s elbows and the joints above and below (shoulders and hands) and asks them to stand	0	1
General inspection around bed and patient (walking aids, obvious scars, wasting or deformities)	0	1
Inspects front for shoulder/hip alignment, limb-limb discrepancy, shoulder architecture	0	1
Inspects back for wasting of muscles (trapezius, paraspinal, deltoids), scoliosis, skin changes, scars, winging of scapulae, elbow nodules, deformities	0	1
Inspects sides for fixed flexion deformities, increased kyphosis or lordosis, carrying angle of the elbow	0	1
Palpates temperature of elbow joint	0	1
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	0	1	2
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	0	1	2
Feels shoulder when moving arm in all planes for crepitus, pain or limitation of movement	0	1
Offers examination of shoulder and hand, neurovascular exam and history	0	1
Thanks patient and offers help to redress	0	1
Washes hands	0	1
Offers next step (imaging: 2 plain x rays for bony pathology or CT if indicated, MRI for soft tissue)	0	1
Summarises appropriately with only key findings	0	1
Offers appropriate differential diagnoses	0	1

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