Diagnosis of Elbow conditions
Elbow conditions Diagnosis: Book Excerpts
Diagnostic Tests for Elbow conditions: Online Medical Books
16 MEDICAL BOOKS ONLINE!
Review excerpts from medical books online, free, without registration,
for more information about diagnostis of Elbow conditions.
Elbow Pain/Swelling:
Differential Diagnosis
(In a Page: Signs and Symptoms)
Trauma
- Fracture
–Radial head fracture is most common: Usually due to a fall on an outstretched arm, resulting in pain with supination
–Olecranon fracture: Pain with extension
–Distal humerus fractures are less common
- Dislocation
–Nursemaid's elbow (subluxation of the radial head) occurs in young children who were pulled by an outstretched arm; children will refuse to move the arm
–In adults, dislocations generally occur secondary to falling on an outstretched arm; 80% are associated with an olecranon fracture
- Bursitis: Due to trauma, inflammation, infection
- Epicondylitis
–Degeneration of the tendinous insertion at the lateral or medial epicondyles
–Lateral epicondylitis (“tennis elbow”): Due to extensor muscle overuse (results in pain with pronation and wrist dorsiflexion)
–Medial epicondylitis (“golfer's elbow”): Due to flexor muscle overuse (results in decreased grip strength and pain with pronation or wrist flexion)
-
Ulnar nerve entrapment
–Usually in the groove of the posterior aspect of the medial epicondyle
–Occurs acutely after direct trauma or with prolonged pressure or overuse
–Causes acute medial aching with numbness and tingling in fourth and fifth digits
Osteoarthritis
Rheumatoid arthritis
Gouty arthritis
Infection
Distal biceps tendon rupture
-
Pronator syndrome
–Median nerve entrapment distal to elbow
from racquet or throwing sports
–Anterior pain and distal paresthesias
–Pain with resisted pronation
-
Radial tunnel syndrome
–Compression of the radial nerve as it crosses the head of the radius
Loose body (e.g., bone fragment)
Workup and Diagnosis
-
History and physical examination
–Include careful exam of the hand, wrist, elbow, and shoulder of the affected side
–Evaluate for pain, paresthesias, bony point tenderness, crepitus on palpation, swelling and ecchymosis, limited range of motion, and neurovascular compromise (e.g., coolness, pallor, loss of distal pulses)
Standard X-rays include A/P, lateral, and oblique views
Aspiration may be diagnostic as well as therapeutic for bursitis; send for cultures and crystals
Occasionally, nerve conduction tests are indicated to evaluate nerve entrapment and/or carpal tunnel syndrome
Rarely, an MRI is indicated; may be considered if the treatment is not progressing as planned
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
ARM PAIN:
Approach to the Diagnosis
(Differential Diagnosis in Primary Care)
The association of other symptoms and signs found on a good history and physical examination is most important in pinpointing the diagnosis. Thus, arm pain with tenderness and limitation of motion at the elbow suggests tennis elbow, gout, or rheumatoid arthritis. Arm pain with loss of sensation in the distribution of the median nerve suggests carpal tunnel syndrome. Injection of lidocaine into bursa or trigger points may be diagnostic.
The laboratory workup should include x-rays of the involved area and of the cervical spine, especially if there is a radicular distribution of the pain. If there are focal neurologic signs, a neurologist should be consulted before ordering an MRI: A cervical rib will not be missed in this way. An ECG and myocardial enzymes may be necessary to exclude a myocardial infarct, and an exercise tolerance test will help exclude coronary insufficiency. Arteriogram, phlebogram, lymphangiogram, electromyogram (EMG) with nerve conduction studies, myelogram, and nerve blocks will be necessary in specific cases.
» READ BOOK EXCERPT ONLINE »
Source: Differential Diagnosis in Primary Care, 2007
ELBOW PAIN:
Approach to the Diagnosis
(Differential Diagnosis in Primary Care)
In the approach to the diagnosis, the traumatic conditions and arthritic disorders will probably stand out. A diagnostic dilemma occurs when the elbow looks normal and has good movement. Nevertheless, most of these cases are caused by tennis elbow, myositis, and fasciitis. Thus, a simple injection at the trigger point will assist the diagnosis and give the patient immediate and sometimes lasting relief. If this is unsuccessful, referral to an orthopedic surgeon is wise.
» READ BOOK EXCERPT ONLINE »
Source: Differential Diagnosis in Primary Care, 2007
Arm pain:
History and physical examination
(Handbook of Signs & Symptoms (Third Edition))
If the patient reports arm pain after an injury, take a brief history of the injury from the patient. Then quickly assess him for severe injuries requiring immediate treatment. If you’ve ruled out severe injuries, check pulses, capillary refill time, sensation, and movement distal to the affected area because circulatory impairment or nerve injury may require immediate surgery. Inspect the arm for deformities, assess the level of pain, and immobilize the arm to prevent further injury.
If the patient reports continuous or intermittent arm pain, ask him to describe it and to relate when it began. Is the pain associated with repetitive or specific movements or positions? Ask him to point out other painful areas because arm pain may be referred. For example, arm pain commonly accompanies the characteristic chest pain of myocardial infarction, and right shoulder pain may be referred from the right upper quadrant abdominal pain of cholecystitis. Ask the patient if the pain worsens in the morning or in the evening, if it prevents him from performing his job, and if it restricts movement. Also ask if heat, rest, or drugs relieve it. Finally, ask about preexisting illnesses, a family history of gout or arthritis, and current drug therapy.
Next, perform a focused examination. Observe the way the patient walks, sits, and holds his arm. Inspect the entire arm, comparing it with the opposite arm for symmetry, movement, and muscle atrophy. (It’s important to know if the patient is right- or left-handed.) Palpate the entire arm for swelling, nodules, and tender areas. In both arms, compare active range of motion, muscle strength, and reflexes.
If the patient reports numbness or tingling, check his sensation to vibration, temperature, and pinprick. Compare bilateral hand grasps and shoulder strength to detect weakness.
If a patient has a cast, splint, or restrictive dressing, check for circulation, sensation, and mobility distal to the dressing. Ask the patient about edema and if the pain has worsened within the last 24 hours.
Examine the neck for pain on motion, point tenderness, muscle spasms, or arm pain when the neck is extended with the head toward the involved side. (See Arm pain: Common causes and associated findings.)
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Arm pain:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
If the patient reports arm pain after an injury, take a brief history of the injury from the patient. Then quickly assess him for severe injuries requiring immediate treatment. If you’ve ruled out severe injuries, check pulses, capillary refill time, sensation, and movement distal to the affected area because circulatory impairment or nerve injury may require immediate surgery. Inspect the arm for deformities, assess the level of pain, and immobilize the arm to prevent further injury.
If the patient reports continuous or intermittent arm pain, ask him to describe it and to relate when it began. Is the pain associated with repetitive or specific movements or positions? Ask him to point out other painful areas because arm pain may be referred. For example, arm pain commonly accompanies the characteristic chest pain of myocardial infarction, and right shoulder pain may be referred from the right-upper-quadrant abdominal pain of cholecystitis. Ask the patient if the pain worsens in the morning or in the evening, if it prevents him from performing his job, and if it restricts any movements. Also ask if heat, rest, or drugs relieve it. Finally, ask about any preexisting illnesses, a family history of gout or arthritis, and current drug therapy.
Next, perform a focused examination. Observe the way the patient walks, sits, and holds his arm. Inspect the entire arm, comparing it with the opposite arm for symmetry, movement, and muscle atrophy. (It’s important to know if the patient is right- or left-handed.) Palpate the entire arm for swelling, nodules, and tender areas. In both arms, compare active range of motion, muscle strength, and reflexes.
If the patient reports numbness or tingling, check his sensation to vibration, temperature, and pinprick. Compare bilateral hand grasps and shoulder strength to detect weakness.
If the patient has a cast, splint, or restrictive dressing, check for circulation, sensation, and mobility distal to the dressing. Ask the patient about edema and if the pain has worsened within the last 24 hours.
Examine the neck for pain on motion, point tenderness, muscle spasms, or arm pain when the neck is extended with the head toward the involved side. (See Arm pain: Causes and associate findings.)
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Elbow Pain:
Differential Overview
(Field Guide to Bedside Diagnosis)
❑Lateral epicondylitis
❑Olecranon bursitis
❑Medial epicondylitis
❑Bicipitoradialis tendinitis
❑Cubital tunnel syndrome
❑Radial head fracture
❑Septic arthritis
❑Gout
❑Osteoarthritis
❑Elbow dislocation
❑Ruptured distal biceps tendon
❑Epitrochlear lymphadenitis
❑Cervical radiculopathy
Diagnostic Approach
Pain arising from within the elbow joint is poorly localized between the lateral epicondyle and the olecranon, and there is inability to straighten the elbow. Referred pain to the elbow is vague, not affected by elbow movement, but increased by movement of the neck or shoulder.
» READ BOOK EXCERPT ONLINE »
Source: Field Guide to Bedside Diagnosis, 2007
Arm pain:
History
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
If the patient reports arm pain after an injury, take a brief history of the injury from the patient. Then quickly assess him for severe injuries requiring immediate treatment. If you’ve ruled out severe injuries, check pulses, capillary refill time, sensation, and movement distal to the affected area because circulatory impairment or nerve injury may require immediate surgery. Inspect the arm for deformities, assess the level of pain, and immobilize the arm to prevent further injury.
If the patient reports continuous or intermittent arm pain, ask him to describe it and to relate when it began. Is the pain associated with repetitive or specific movements or positions? Ask him to point out other painful areas because arm pain may be referred. For example, arm pain commonly accompanies the characteristic chest pain of myocardial infarction, and right shoulder pain may be referred from the right-upper-quadrant abdominal pain of cholecystitis. Ask the patient if the pain worsens in the morning or in the evening, if it prevents him from performing his job, and if it restricts any movements. Also ask if heat, rest, or drugs relieve it. Finally, ask about any preexisting illnesses, a family history of gout or arthritis, and current drug therapy.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Arm pain:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
If the patient reports arm pain after an injury, take a brief history of the injury from the patient. Quickly assess him for severe injuries requiring immediate treatment. If you've ruled out severe injuries, check pulses, capillary refill time, sensation, and movement distal to the affected area because circulatory impairment or nerve injury may require immediate surgery. Inspect the arm for deformities, assess the level of pain, and immobilize the arm to prevent further injury.
If the patient reports continuous or intermittent arm pain, ask him to describe it and to relate when it began. Is the pain associated with repetitive or specific movements or positions? Ask him to point out other painful areas because arm pain may be referred. For example, arm pain commonly accompanies the characteristic chest pain of myocardial infarction, and right shoulder pain may be referred from the right upper quadrant abdominal pain of cholecystitis. Ask the patient if the pain worsens in the morning or in the evening, if it prevents him from performing his job, and if it restricts movement. Ask if heat, rest, or drugs relieve it. Finally, ask about preexisting illnesses, a family history of gout or arthritis, and current drug therapy.
Next, perform a focused examination. Observe the way the patient walks, sits, and holds his arm. Inspect the entire arm, comparing it with the opposite arm for symmetry, movement, and muscle atrophy. (It's important to know if the patient is right- or left-handed.) Palpate the entire arm for swelling, nodules, and tender areas. In both arms, compare active range of motion, muscle strength, and reflexes.
If the patient reports numbness or tingling, check his sensation to vibration, temperature, and pinprick. Compare bilateral hand grasps and shoulder strength to detect weakness.
If a patient has a cast, splint, or restrictive dressing, check for circulation, sensation, and mobility distal to the dressing. Ask the patient about edema and if the pain has worsened within the last 24 hours.
Examine the neck for pain on motion, point tenderness, muscle spasms, or arm pain when the neck is extended with the head toward the involved side.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
ARM PAIN:
Approach to the Diagnosis
(Differential Diagnosis in Primary Care)
The association of other symptoms and signs found on a good history and
physical examination is most important in pinpointing the diagnosis. Thus,
arm pain with tenderness and limitation of motion at the elbow suggests
tennis elbow, gout, or rheumatoid arthritis. Arm pain with loss of sensation
in the distribution of the median nerve suggests carpal tunnel syndrome.
Injection of lidocaine into bursa or trigger points may be diagnostic.
The laboratory workup should include x-rays of the involved area and of the
cervical spine, especially if there is a radicular distribution of the pain.
If there are focal neurologic signs, a neurologist should be consulted
before ordering an MRI: A cervical rib will not be missed in this way. An
ECG and myocardial enzymes may be necessary to exclude a myocardial infarct,
and an exercise tolerance test will help to exclude coronary insufficiency.
Arteriogram, phlebogram, lymphangiogram, electromyogram with nerve
conduction studies, myelogram, and nerve blocks will be necessary in
specific cases.
» READ BOOK EXCERPT ONLINE »
Source: Differential Diagnosis in Primary Care, 2007
ELBOW PAIN:
Approach to the Diagnosis
(Differential Diagnosis in Primary Care)
In the approach to the diagnosis, the traumatic conditions and
arthritic disorders will probably stand out. A diagnostic dilemma occurs
when the elbow looks normal and has good movement. Nevertheless, most of
these cases are caused by tennis elbow, myositis, and fasciitis. Thus, a
simple injection at the trigger point will assist the diagnosis and give the
patient immediate and sometimes lasting relief. If this is unsuccessful,
referral to an orthopedic surgeon is wise.
» READ BOOK EXCERPT ONLINE »
Source: Differential Diagnosis in Primary Care, 2007
When prostate cancer spreads, a common site is bone. This results in weakened bones that cause pain and are prone to fracture. Learn how these bone...
"I authorize the release of any medical or other information necessary to process this claim." Do you recognize these words? You should, if...
Whenever you go to a hospital or clinic for a major procedure or diagnostic test, one of the many forms you are given to sign is an "informed...
Germs are a fact of life and catching an infectious disease like a cold may seem inevitable. But there are simple ways to protect yourself against...
See full list of 4 related videos
» Next page: Signs of Elbow conditions
Rate This Website
What do you think about the features of this website?
Take our user survey and have your say:
Website User Survey
Medical Tools & Articles:
Next articles:
Tools & Services:
Medical Articles:
Forums & Message Boards
- Ask or answer a question at the Boards:
