I.

Pain
Pain from the elbow is fairly diffuse and may extend into the
forearm
The patient may have noticed that it is triggered, or
aggravated, by certain activities
tennis elbow for lateral epicondylar pain and golfers
elbow for medial epicondylar pain
II. Stiffness
The patient may be unable to reach up to the mouth
(loss of exion)
loss of extension
limited supination makes it difcult to carry large
objects

III. Swelling
injury or inammation
a soft lump on the back of the elbow suggests an
olecranon bursitis.
IV. Deformity
is uncommon except in rheumatoid arthritis and after trauma.
Always ask about previous injuries.

IV. Instability
the feeling that the elbow moves out of joint is due either to
previous trauma or to destructive joint disease.

IV. Ulnar nerve symptoms

(tingling, numbness and weakness of the hand) may occur in
elbow disorders because of the nerves proximity to the
joint.

IV. Loss of function is noticed mainly in grooming, carrying and

placing activities.
Look
The patient holds his or her arms alongside the body,
elbows fully extended, with palms forwards.
In this position the forearms are normally angled
slightly outwards a valgus or carrying angle of 515
degrees.
Varus or valgus deformity is determined by angular
deviations medialwards or lateralwards beyond those
limits or, in unilateral abnormalities, by comparison
with the normal side.
Varus and valgus deformities (cubitus varus and
cubitus valgus)
usually the result of trauma around the elbow.
By far the best way to demonstrate a varus deformity is to ask the
patient to lift his or her arms sideways to shoulder height; in this
position the deformity becomes much more obvious, the arm
taking on the appearance of a rie butt (gunstock deformity)
Feel
Start by identifying the most obvious bony landmarks: the olecranon
process posteriorly, the medial and lateral epicondyles and the head of
the radius just distal to the lateral epicondyle;
pronating and supinating the forearm makes it easier to nd the mobile
radial head and the lateral joint line.
The ulna can be palpated throughout its length, the radius only at its
proximal end and in the distal third of the forearm.
The back of the elbow is palpated for warmth and swelling (signs of an
olecranon bursitis) and subcutaneous nodules (a feature of rheumatoid
arthritis).
Feel more widely for synovial thickening and uid (uctuation on each
side of the olecranon).
Last of all, feel for tenderness and try to determine which structure is

affected.
Move