Pathologies of the Elbow
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Transcript 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)
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
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.
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