Download Pathologies of the Elbow

Pathologies of the Elbow By Stephanie Belsh And Bobbi Snow

Lateral Epicondylitis (tennis elbow) 

Pathology  30 – 50 years old  Repetitive micro-trauma  Chronic tear in the origin of the extensor carpi radialis brevis lateral epicondyle  Muscle imbalance

Lateral Epicondylitis (tennis elbow) 

Mechanism of Injury  Overuse syndrome caused by repeated forceful wrist and finger movements  Tennis players  Prolonged and rapid activities

Lateral Epicondylitis (tennis elbow) 

Clinical Signs and Symptoms  Increased pain  Tenderness in palpation  Tests  Passive  Active  Lidocaine

Medial Epicondylitis (golfer’s elbow) 

Pathology  30 - 50 years old  Repetitive micro trauma  Muscle imbalance

Medial Epicondylitis (golfer’s elbow) 

Mechanisms of injury  Throwing a baseball  Racquetball or tennis  Swimming backstroke  Hitting a golf ball

Medial Epicondylitis (golfer’s elbow) 

Clinical signs and symptoms  Increased pain  Tenderness on palpation  Tests  Passive  Active  Lidocaine

Lateral and Medial Epicondylitis Common Treatments  Physical Therapy  Medical  Surgery  Injury prevention 

Ulnar Neuritis 

Pathology  Superficial position at the elbow  Excessive pressure in this area  30-60 years  Second most common entrapment neuropathy in the upper extremity

Ulnar Neuritis 

Mechanism of injury  Repeated activities  Compression of the ulnar nerve  Fractures  Dislocation

Ulnar Neuritis 

Clinical signs and symptoms  Local tenderness  R/O subluxation  Nerve conduction study/EMG  Sensory changes  Delayed injury onset

Ulnar Neuritis Common treatments  Non-operative  Surgical intervention  Preventions 

Medial Overload Syndrome in Throwers Pathology  Repetitive stress  Mechanism of injury  Pitching  Partial or complete avulsion of the medial apophysis  Articular cartilage and subchondral bone changes 

Medial Overload Syndrome in Throwers 

Mechanism of injury (continued)  Avulsion of the posterior olecranon epiphysis  Stress fracture  Ulnar nerve neuritis medially

Medial Overload Syndrome in Throwers 

Clinical signs and symptoms  Persistent medial elbow soreness  Arm fatigue is the 1st indicator of impending injury  Medial tenderness  Elbow pain

Medial Overload Syndrome in Throwers Common treatments  Non-operative  Surgical interventions  Prevention. 

Pronator Tunnel Syndrome (proximal median nerve compression) 

Pathology  Possible sights of compression  Between the humeral and Ulnar heads of Pronator Teres  Supracondylar process of the humerus  Lacertus fibrosus  Proximal edge of the flexor digitorum superficialis

Pronator Tunnel Syndrome (proximal median nerve compression) 

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Mechanism for injury  Women  Repetitive movements Clinical Signs and Symptoms  Pain in the anterior forearm  Paresthesias or dysesthesias  Altered sensation  Tests

Pronator Tunnel Syndrome (proximal median nerve compression) Common Treatments  Physical Therapy  Medical  Surgery  Injury prevention 

Anterior Interosseus Nerve Syndrome 

Pathology  Areas of possible compression  Between the head of the pronator teres  The proximal tendon of flexor digitorum superficialis  An accessory muscle

Anterior Interosseus Nerve Syndrome 

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Mechanism for Injury  Repetitive elbow flexion with forearm pronated  Spontaneously  Trauma or fractures Clinical Signs and Symptoms  Pain  No sensory complaints or losses  Significant muscular weakness

Anterior Interosseus Nerve Syndrome Common Treatments  Physical Therapy  Medical  Surgery  Injury prevention 

Radial Tunnel syndrome 

Pathology  Radial nerve compressed: In the proximal radial tunnel  The tendon of extensor carpi radialis brevis  The superficial part of the supinator tendon. 

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Mechanism of injury

Radial Tunnel syndrome Clinical signs and symptoms  Pain and discomfort  Sensory changes  Low dexterity in finger extension  Resistive tests  Common treatments  Prevention 

Posterior Interosseous Nerve Syndrome Pathology  Compression or entrapment of the nerve  Mechanism of injury  Repetitive motion  Clinical signs and symptoms  Pain 

Posterior Interosseous Nerve Syndrome Clinical signs and symptoms (cont.)  Loss of active extension  Tenderness  Weakness  Common treatments  Prevention 

The End