Overview

Source: Robert E. Sallis, MD. Kaiser Permanente, Fontana, California, USA

The elbow is a hinged joint that involves the articulation of 3 bones: the humerus, radius, and ulna. It is a much more stable joint than the shoulder, and because of that, the elbow has less range of motion. The elbow and its structures are prone to significant injuries, particularly with repetitive motion. Lateral and medial epicondylitis (also called tennis elbow and golfer's elbow) are two common diagnoses and often occur as a result of occupational activities.

When examining the elbow, it is important to remove enough clothing so that the entire shoulder and elbow can be inspected. It is important to compare the injured elbow to the uninvolved side. A systematic evaluation of the elbow includes inspection, palpation, range of motion (ROM) testing, and special tests, including maneuvers to evaluate ligamentous stability and stretch tests to accentuate pain caused by epicondylitis.

Procedure

1. Inspection

When inspecting the elbow, compare to the uninvolved side while looking for swelling, redness, warmth, and carrying angle.
If swelling is present, determine if it is in the bursa or in the joint. Swelling in the elbow joint will appear anteriorly at the brachial fossa. The most common site for swelling in the elbow is posterior, in the olecranon bursa.
Note if redness or warmth is present; these may suggest olecranon bursitis or infection.
Compare the size of the el

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Application and Summary

Examination of the elbow is best done by following a stepwise approach with the patient in a sitting position. It is important to have the patient remove enough clothing so that that surface anatomy can be seen and compared to the uninvolved side. The exam should begin with inspection, looking for asymmetry between the involved and uninvolved elbow. Next, palpation of key structures is done, looking for tenderness, swelling or deformity.

This is followed by assessing ROM, first actively and th

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Elbow Exam