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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.

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Pathologies of the Elbow

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  1. Pathologies of the Elbow By Stephanie Belsh And Bobbi Snow

  2. 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

  3. Lateral Epicondylitis (tennis elbow) • Mechanism of Injury • Overuse syndrome caused by repeated forceful wrist and finger movements • Tennis players • Prolonged and rapid activities

  4. Lateral Epicondylitis (tennis elbow) • Clinical Signs and Symptoms • Increased pain • Tenderness in palpation • Tests • Passive • Active • Lidocaine

  5. Medial Epicondylitis (golfer’s elbow) • Pathology • 30 - 50 years old • Repetitive micro trauma • Muscle imbalance

  6. Medial Epicondylitis (golfer’s elbow) • Mechanisms of injury • Throwing a baseball • Racquetball or tennis • Swimming backstroke • Hitting a golf ball

  7. Medial Epicondylitis (golfer’s elbow) • Clinical signs and symptoms • Increased pain • Tenderness on palpation • Tests • Passive • Active • Lidocaine

  8. Lateral and Medial Epicondylitis • Common Treatments • Physical Therapy • Medical • Surgery • Injury prevention

  9. 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

  10. Ulnar Neuritis • Mechanism of injury • Repeated activities • Compression of the ulnar nerve • Fractures • Dislocation

  11. Ulnar Neuritis • Clinical signs and symptoms • Local tenderness • R/O subluxation • Nerve conduction study/EMG • Sensory changes • Delayed injury onset

  12. Ulnar Neuritis • Common treatments • Non-operative • Surgical intervention • Preventions

  13. 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

  14. Medial Overload Syndrome in Throwers • Mechanism of injury (continued) • Avulsion of the posterior olecranon epiphysis • Stress fracture • Ulnar nerve neuritis medially

  15. 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

  16. Medial Overload Syndrome in Throwers • Common treatments • Non-operative • Surgical interventions • Prevention.

  17. 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

  18. 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

  19. Pronator Tunnel Syndrome (proximal median nerve compression) • Common Treatments • Physical Therapy • Medical • Surgery • Injury prevention

  20. 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

  21. 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

  22. Anterior Interosseus Nerve Syndrome • Common Treatments • Physical Therapy • Medical • Surgery • Injury prevention

  23. 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

  24. Radial Tunnel syndrome • Clinical signs and symptoms • Pain and discomfort • Sensory changes • Low dexterity in finger extension • Resistive tests • Common treatments • Prevention

  25. Posterior Interosseous Nerve Syndrome • Pathology • Compression or entrapment of the nerve • Mechanism of injury • Repetitive motion • Clinical signs and symptoms • Pain

  26. Posterior Interosseous Nerve Syndrome • Clinical signs and symptoms (cont.) • Loss of active extension • Tenderness • Weakness • Common treatments • Prevention

  27. The End

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