Elbow Orthopaedic

Tests

Medial Aspect (Ulnar

Nerve)

Medial Epicondyle

Ulnar Collateral
Ligament

Lateral Epicondyle

Radial Collateral
Ligament
Annular Ligament

Olecranon Process and

Bursa

Triceps

Lateral Epicondylitis
(Tennis Elbow)
Lateral epicondylitis is a repetitive strain
injury of the common extensor tendon at
thelateral epicondyle of the humerus.
Symptoms persist because of constant
traction movement of the wrist and hand.

Lateral Epicondylitis
(Tennis Elbow)

Lateral Epicondylitis
(Tennis Elbow)
Clinical Signs and Symptoms
Local lateral elbow pain
Weakness of the forearm

Cozens Test
Procedure: Patient seated. Stabilize
forearm. Patient should make a fist and
extend it against resistance.
Rationale: The tendons that extend the
wrist attach to the lateral epicondyle.
Forcing the extended wrist into flexion will
exacerbate the pain if the tendons are
inflamed.

Cozens Test

Mills Test
Procedure: Patient seated. Instruct the
patient to pronate the arm and flex the
wrist. Then, instruct them to supinate
against resistance.
Rationale: The supinator tendon is
attached to the lateral epicondyle. If pain
is elicited, suspect inflammation of the
lateral epicondyle.

Mills Test

Medial Epicondylitis
(Golfers Elbow)
Medial epicondylitis is a repetitive injury of
the common flexor tendon at the medial
epiconsyle of the humerus.
Symptoms persist due to constant traction
and movement of the wrist and hand.

Medial Epicondylitis
(Golfers Elbow)
Clinical Signs and Symptoms
Local medial elbow pain
Weakness of the forearm

Medial Epicondylitis
(Golfers Elbow)

Golfers Elbow test

Procedure: Patient seated. Instruct the
patient to extend the elbow and supinate
the hand. Then, instruct the patient to flex
the wrist against resistance.
Rationale: The tendons that flex the wrist
are attached to the medial epicondyle. If
pain is elicited, suspect inflammation of
the medial epicondyle.

Golfers Elbow test

Ligamentous Instability
Ligamentous instability of the elbow is
relatively uncommon.
The injury may be caused by forced elbow
hyperextension, forced abduction of the
extended arm, or forced adduction of the
extended arm.

Ligamentous Instability
Forced adduction will damage the radial
collateral ligament.
Forced abduction will damage the ulnar
collateral ligament.

Ligamentous Instability
Clinical Signs and Symptoms
Medial or Lateral elbow pain
Local swelling

Adduction Stress Test

Procedure: Patient seated. Stabilize the
medial arm and place adduction pressure
on the patients lateral forearm.
Rationale: Adduction pressure will stress
the radial collateral ligament. Gapping
and pain indicate radial collateral ligament
instability.

Adduction Stress Test

Abduction Stress Test

Procedure: Patient seated. Stabilize the
lateral arm and place abduction pressure
on the medial forearm.
Rationale: Abduction pressure on the
medial forearm applies stress to the ulnar
collateral ligament. Gapping and pain
indicate ulnar collateral ligament
instability.

Abduction Stress Test

Neuropathy /
Compression
Syndromes
Neuropathy and compression syndromes of
the elbow are peripheral neurological
disorders.
They are caused by trauma, overuse,
arthritis, and postural considerations.

Neuropathy /
Compression
Syndromes
Paresthesia and weakness of the forearm
and/or hand.
The ulnar nerve is most often affected.
Compression occurs in the groove between
the olecranon process and the medial
epicondyle or the cubital tunnel.

Neuropathy /
Compression
Syndromes
Clinical Signs and Symptoms
Forearm and/or hand paresthesia
Forearm and/or hand weakness

Tinels Sign
Procedure: Patient seated. Tap the ulnar
nerve in the groove between the olecranon
process and the medial epicondyle with a
neurological reflex hammer.
Rationale: If pain is elicited, it suggests a
neuritis or neuroma of the ulnar nerve.

Tinels Sign

Causes of Ulnar Nerve

Damage
Excessive use or repetitive motion injuries.
Arthritis of the elbow joint.
Cubital tunnel compression, between the
heads of the flexor carpi ulnaris muscle.
Postural habits that compress the nerve,
such as sleeping with elbows flexed and
hands under head.
Recurrent nerve subluxations or dislocations.