Elbow Pain: Etiology, Signs, and Special Tests

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Questions and Answers

What is the most common elbow fracture in kids involving the distal portion of the humerus?

Nursemaid's Elbow

Medial Epicondylitis

Fracture of Distal Humerus (Supracondylar) (correct)

Radial Head Subluxation

What is the characteristic X-ray finding in a Trauma-related fracture that presents with 'Sail's sign'?

Medial view

Lateral view (correct)

Oblique view

AP view

Which treatment option is preferred for a Type III radial head fracture?

NSAID

Early ROM exercise

Surgical fixation (pins) (correct)

What is the common term for a condition where the radial head slips partially out of the annular ligament causing significant pain?

Radial Head Subluxation Signup and view all the answers

Which type of fracture should be treated with early ROM exercise and a sling for 3-5 days?

Type I Radial Head Fracture Signup and view all the answers

What is another term for Medial Epicondylitis due to a repetition injury at the medial elbow?

Golfer's Elbow Signup and view all the answers

What is the most common cause of posterior elbow pain according to the text?

Fracture of the Olecranon Signup and view all the answers

Which condition is characterized by swelling within the olecranon bursa leading to limiting symptoms?

Olecranon Bursitis Signup and view all the answers

What conservative approach is suggested for managing lateral elbow pain due to repetitive wrist extension?

Adapt mechanism if possible Signup and view all the answers

Which action is advised if concerned about an infection related to posterior elbow pain?

Aspirate and test sample Signup and view all the answers

What is a common test mentioned for confirming lateral epicondylitis?

+Tinel's EMG/NCS Signup and view all the answers

In what timeframe does surgical reattachment/repair provide the best results for a posterior elbow muscle tear?

1-2 weeks post injury Signup and view all the answers

What is a common etiology of anterior elbow pain?

Distal Biceps Tendon Rupture Signup and view all the answers

Which condition may present with pain, swelling, and effusion in the elbow?

Traumatic OA Signup and view all the answers

What is a common special test used for diagnosing septic joint in the elbow?

Aspiration and culture Signup and view all the answers

What treatment is typically recommended for elbow osteoarthritis (OA)?

PT and Arthroscopic repair Signup and view all the answers

Which condition may cause weakness in supination in males over 40 years old?

Cubital Tunnel Syndrome Signup and view all the answers

What is the abbreviation TEA referred to in the context of elbow conditions?

Total Elbow Arthroplasty Signup and view all the answers

What is the name of the ligament tear mentioned in the text?

Ulnar Collateral Ligament Tear Signup and view all the answers

What is the preferred treatment approach mentioned in the text for the UCL Tear?

Conservative management Signup and view all the answers

What is the anatomical location of the UCL Tear mentioned in the text?

Wrist Signup and view all the answers

Which of the following is NOT mentioned as a conservative treatment option for the UCL Tear?

Physiotherapy Signup and view all the answers

What is the name of the surgical procedure mentioned in the text for treating UCL Tear?

Tommy John Surgery Signup and view all the answers

Which of the following is NOT listed as a component of the patient history essential for evaluating shoulder pathology?

Family history Signup and view all the answers

Which of the following clinical landmarks is utilized in the examination of the shoulder?

Deltoid muscle Signup and view all the answers

Study Notes

Anterior Elbow Pain

Etiology: Osteoarthritis, Rheumatoid arthritis, Gout tophus, Septic joint
MC: Rheumatoid arthritis
General: Pain at site, Swelling, Effusion, Nodules, W/ or w/o fever
Special Tests: Aspiration, OA: joint space narrowing +/osteophytes, Gout: Aspirate, Septic: Aspirate, Culture, CBC for WBC count
Treatment: All: Attempt CS injections, RA: GOLD, DMARD, Optimize NSAIDs, TEA if needed, OA: PT, Arthroscopic repair, TEA, Gout: XOI/Steroids, Septic: IV antibiotics, Surgical intervention

Distal Biceps Tendon Rupture

Etiology: Lifting heavy stuff causes excessive force on distal tendon attachment
General: Weakness in supination, Sudden, sharp pain, Bruising, Muscle bulging
MRI: Determine completeness of tear
Treatment: TEA (total elbow arthroplasty)

Cubital Tunnel Syndrome

Etiology: Pressure on ulnar nerve at the elbow
General: Weakness in supination, Sudden, sharp pain, Bruising, Muscle bulging
Posterior Elbow Pain: Pain in medial/post elbow, Paresthesis in ring & small finger
Treatment: Conservative: Adapt mechanism, (+) Tinel's, EMG/NCS

Olecranon Bursitis

Etiology: Swelling within the olecranon bursa
General: Pain & limited ROM, +/- erythema, visually obvious
Treatment: Aspirate and test sample, Otherwise: Compression, Bursectomy if recurrent, NSAIDs

Fracture of the Olecranon

Etiology: FOOSH fracture and/or dislocation
General: Pain & limited ROM, +/- erythema
Treatment: MC: 90% displaced, Surgical reattachment/repair, 1-2wk post injury for best results

Lateral Epicondylitis

Etiology: Repetition injury
General: Pain in lateral elbow, Weakness in supination
Treatment: Conservative: Adapt mechanism, (+) Tinel's, EMG/NCS, Surgical: Create new space for nerve, Reduce impingement

Ulnar Collateral Ligament Tear (UCL Tear)

Etiology: Weightlifters
General: Pain in medial aspect (MCL) with flexion and pronation
Clinical: Wrist flexion, Wrist pronation
Treatment: Conservative: Compression brace, NSAID, CS Injection, Stretching, Surgical: not preferred

Fracture of Distal Humerus (Supracondylar)

Etiology: Trauma in kids
General: Pain, "Sail's sign" (posterior fat pad)
XRAY: AP, Lateral
Treatment: Surgical: Fixation (pins), Post-op splinting/casting, Type I: Sling for 3-5 days, Early ROM exercise, Type II: Displaced, Type III: Comminuted

Fracture of Radial Head

Etiology: FOOSH, Valgus force
General: Pain, Swelling at lateral elbow, Limited ROM
XRAY: AP, Lateral, Oblique
Treatment: Type I: Non-displaced, Type II: Displaced, Type III: Comminuted

Radial Head Subluxation (Nursemaid's Elbow)

Etiology: Swinging/extension in < 6YO kids
General: Pain, Refusal to use arm
Treatment: Must reduce, Fully extend elbow, Fully flex

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Description

Learn about the causes, signs, and special diagnostic tests for elbow pain conditions like Elbow Osteoarthritis, Rheumatoid Arthritis, Gout Tophus, and Septic Joint. Explore common symptoms such as pain, swelling, effusion, and nodules, along with relevant treatments including corticosteroid injections and disease-modifying antirheumatic drugs (DMARDs).