OnExam

Inspection

  • Inspect with patient standing
    • Carrying angle of the arm (normal = 15° from midline)
    • Inspect olecranon process
    • Medial and lateral epicondyles
    • Note any posterior displacement of olecranon
    • Note any boney enlargement, swelling, erythema and or deformity
    • Inspect for supracondylar fracture of elbow

Palpation

  • Note areas of pain, swelling, spasm, muscular atrophy, ligamentous laxity, deformity, bogginess or crepitus in the following structures:
    • Medial and lateral epicondyles
    • Olecranon process
    • Olecranon bursa
      • Olecranon bursitis
    • Flexor surface
    • Extensor surface
    • Palpate interspace between olecranon and condyles
      • Ulnar nerve (between olecranon process and medial epicondyle)
        • If pain reproduced with compression, possible ulnar nerve entrapment
      • Radial nerve (between lateral epicondyle & radial head)
      • Radial head and radiohumeral joint/radioulnar joint
        • Palpation can occur in pronated position, followed by neutral & supinated posiitons
      • Synovial membrane of joint
      • Note deformities
        • Posterior dislocation of elbow
        • Supracondylar fracture of elbow

Range of Motion

References

  1. Baxter S, ed., McScheffrey G, ed. Toronto Notes: Comprehensive Medical Reference & Review for MCCQE 1 & USMLE 2. 26th ed. Toronto: Toronto Notes for Medical Students Inc; 2010.
  2. Bickley L. Bate’s Guide to Physical Examination and History Taking. 11th ed. New York: Lippincott Williams & Wilkins; 2013.
  3. Filate W, Leung R, Ng D, Sinyor M, eds. Essentials of Clinical Examination Handbook. 5th ed. Toronto, ON. University of Toronto, 2005.