Pathologies of the Elbow

Pathologies of the Elbow

ByBy

Stephanie BelshStephanie Belsh

And And

Bobbi SnowBobbi Snow

Lateral Epicondylitis (tennis elbow)

PathologyPathology 30 – 50 years old30 – 50 years old Repetitive micro-trauma Repetitive micro-trauma Chronic tear in the origin of the extensor Chronic tear in the origin of the extensor

carpi radialis brevis lateral epicondylecarpi radialis brevis lateral epicondyle Muscle imbalanceMuscle imbalance


Mechanism of InjuryMechanism of Injury Overuse syndrome caused by repeated Overuse syndrome caused by repeated

forceful wrist and finger movementsforceful wrist and finger movements Tennis playersTennis players Prolonged and rapid activitiesProlonged and rapid activities


Clinical Signs and Symptoms Clinical Signs and Symptoms Increased pain Increased pain Tenderness in palpation Tenderness in palpation TestsTests

Passive Passive Active Active Lidocaine Lidocaine

Medial Epicondylitis (golfer’s elbow)

PathologyPathology 30 - 50 years old30 - 50 years old Repetitive micro traumaRepetitive micro trauma Muscle imbalanceMuscle imbalance


Mechanisms of injuryMechanisms of injury Throwing a baseballThrowing a baseball Racquetball or tennisRacquetball or tennis Swimming backstrokeSwimming backstroke Hitting a golf ballHitting a golf ball


Clinical signs and symptomsClinical signs and symptoms Increased painIncreased pain Tenderness on palpationTenderness on palpation TestsTests

PassivePassiveActiveActiveLidocaineLidocaine

Lateral and Medial Epicondylitis

Common TreatmentsCommon Treatments Physical TherapyPhysical Therapy MedicalMedical SurgerySurgery

Injury preventionInjury prevention

Ulnar Neuritis

PathologyPathology Superficial position at the elbowSuperficial position at the elbow Excessive pressure in this areaExcessive pressure in this area 30-60 years30-60 years Second most common entrapment Second most common entrapment

neuropathy in the upper extremityneuropathy in the upper extremity

Ulnar Neuritis

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

Ulnar Neuritis

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

Ulnar Neuritis

Common treatmentsCommon treatments Non-operativeNon-operative Surgical interventionSurgical intervention

PreventionsPreventions

Medial Overload Syndrome in Throwers

PathologyPathology Repetitive stress Repetitive stress

Mechanism of injury Mechanism of injury Pitching Pitching Partial or complete avulsion of the medial Partial or complete avulsion of the medial

apophysis apophysis Articular cartilage and subchondral bone Articular cartilage and subchondral bone

changes changes


Mechanism of injuryMechanism of injury (continued) (continued) Avulsion of the posterior olecranon Avulsion of the posterior olecranon

epiphysis epiphysis Stress fracture Stress fracture Ulnar nerve neuritis medially Ulnar nerve neuritis medially


Clinical signs and symptomsClinical signs and symptoms Persistent medial elbow sorenessPersistent medial elbow soreness Arm fatigue is the 1Arm fatigue is the 1stst indicator of indicator of

impending injuryimpending injury Medial tenderness Medial tenderness Elbow pain Elbow pain


Common treatmentsCommon treatments Non-operativeNon-operative Surgical interventionsSurgical interventions

Prevention.Prevention.

Pronator Tunnel Syndrome (proximal

median nerve compression) PathologyPathology

Possible sights of compressionPossible sights of compression Between the humeral and Ulnar heads Between the humeral and Ulnar heads

of Pronator Teresof Pronator Teres Supracondylar process of the humerusSupracondylar process of the humerus Lacertus fibrosusLacertus fibrosus Proximal edge of the flexor digitorum Proximal edge of the flexor digitorum

superficialissuperficialis

Pronator Tunnel Syndrome (proximal median nerve compression)

Mechanism for injuryMechanism for injury WomenWomen Repetitive movements Repetitive movements

Clinical Signs and Symptoms Clinical Signs and Symptoms Pain in the anterior forearm Pain in the anterior forearm Paresthesias or dysesthesias Paresthesias or dysesthesias Altered sensation Altered sensation TestsTests

Pronator Tunnel Syndrome (proximal median nerve compression)


Injury prevention Injury prevention

Anterior Interosseus Nerve Syndrome

PathologyPathology Areas of possible compressionAreas of possible compression

Between the head of the pronator teresBetween the head of the pronator teres The proximal tendon of flexor The proximal tendon of flexor

digitorum superficialisdigitorum superficialis An accessory muscleAn accessory muscle


Mechanism for InjuryMechanism for Injury Repetitive elbow flexion with forearm pronated Repetitive elbow flexion with forearm pronated Spontaneously Spontaneously Trauma or fractures Trauma or fractures

Clinical Signs and Symptoms Clinical Signs and Symptoms Pain Pain No sensory complaints or losses No sensory complaints or losses Significant muscular weaknessSignificant muscular weakness



Injury preventionInjury prevention

Radial Tunnel syndrome

PathologyPathology Radial nerve compressed:Radial nerve compressed:

In the proximal radial tunnel In the proximal radial tunnel The tendon of extensor carpi radialis brevisThe tendon of extensor carpi radialis brevisThe superficial part of the supinator tendon.The superficial part of the supinator tendon.

Mechanism of injuryMechanism of injury

Radial Tunnel syndrome

Clinical signs and symptomsClinical signs and symptoms PainPain and discomfort and discomfort Sensory changes Sensory changes Low dexterity in finger extension Low dexterity in finger extension Resistive testsResistive tests

Common treatments Common treatments Prevention Prevention

Posterior Interosseous Nerve Syndrome

PathologyPathology Compression or entrapment of the nerve Compression or entrapment of the nerve

Mechanism of injuryMechanism of injury Repetitive motion Repetitive motion

Clinical signs and symptoms Clinical signs and symptoms Pain Pain

Posterior Interosseous Nerve Syndrome

Clinical signs and symptoms (cont.)Clinical signs and symptoms (cont.) Loss of active extensionLoss of active extension Tenderness Tenderness Weakness Weakness

Common treatments Common treatments PreventionPrevention

The End

Documents

Pathologies of the Elbow