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