Elbow Examination

The elbow exam is a simple examination that can be administered as part of the physical exam to help guide healthcare providers diagnosis and management of acute elbow fractures. The elbow examination is performed when an elbow fracture, most commonly caused by trauma, is suspected as the source of pain and dysfunction.

Subject steps
1. Begin by washing your hands. Explain the procedure to the patient and gain informed consent to continue. 2. Begin with observation of the patient. Inspect the front to check the carrying angle, from the side to check for a fixed flexion deformity, and from behind and on the inside to check for scars, swellings, rashes, rheumatoid nodules and psoriatic plaques.

Inspect the front

Inspect the side

Inspect behind and on the inside 3. Feel the elbow, assessing the joint temperature relative to the rest of the arm. Palpate the olecranon process as well as the lateral and medial epicondyles for tenderness.

Assess the joint temperature

Palpate the olecranon process 4. The movements at the elbow joint are all fairly easy to describe and assess. These are flexion, extension, pronation and supination. Once these have been assessed actively they should be checked passively checking for crepitus.

Flexion joint movement

Extension joint movement

Pronation joint movement

Supination joint movement

5. Finally you should check for tennis elbow and golfers elbow. Tennis elbow localises pain over the lateral epicondyle, particularly on active extension of the wrist with the elbow bent. Golfers elbow pain localises over the medial epicondyle and is made worse by flexing the wrist. Check each of these individually to eliminate them.

Check for tennis elbow

Check for golfers elbow 6. On completion, thank the patient for their time and wash your hands.