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Elbow Pathology: Diagnosis and Treatment Options

Explore various elbow pathologies such as Capsular Osteoarthritis, Rheumatoid Arthritis, Traumatic Arthritis, and Bicipital Bursitis. Learn about conditions like Tennis Elbow and Golfer's Elbow, along with treatment options including injections, mobilization, and rest.

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Elbow Pathology: Diagnosis and Treatment Options

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  1. The Elbow Differential Diagnosis & Treatment

  2. Pathology • Throwing, hitting, punching, pushing, painting • Shoulder dysfunction • Cervical spine pathology

  3. Capsular

  4. Osteoarthritis • Post traumatic • Capsular pattern • Crepitus • Older patient • Electrotherapy and mobilisation or injec into joint

  5. Rheumatoid Arthritis • Lax ligaments – reduced stability • Synovial thickening and swelling, flexion deformity • Steroid injec and rest or oral medication

  6. Traumatic Arthritis • Cause – fall or hyperextension • Acute – x-ray and aspirate • Sub acute – steroid injection and rest or 1 week rest in flex and gradual gentle mobs • No friction – myositis ossificans

  7. Non capsular

  8. Loose body eg Osteochondritis Dissecans and OA • Pain and springy end feel • Locking • Either in coronoid or olecranon fossa • Treatment • EUA removal

  9. Cubitus varus and valgus • Reduced or increased carrying angle • Following fracture • Children • Epiphyseal damage • May need surgical correction

  10. Bicipital Bursitis • Pain at front of elbow • Pain – full passive pronation • Some pain on resisted flexion in supin • Treatment - injec

  11. Olecranon Bursitis • Posterior elbow pain • Pain on full passive flexion • Some pain on resisted exten • Carpet fitters, RA, students • Treatment – aspiration and /or injection

  12. Contractile

  13. Tennis Elbow • Causes: • 2 joint muscle – lengthening across 2 • joints + added force – sheer stress at origin • Overuse • Gripping

  14. Tennis Elbow • Pathology • 6months – 2years • Microscopic tears – failed healing - inflammation • Fibroblasts • Vascular hyperplasia • Disorganised collagen • Tendinitis or tendinosis

  15. On examination • 20-30’s most common and degen 40yrs + • Pain on resisted wrist extension with elbow extension • Reduced grip strength • Pain on palpation

  16. Lateral Epicondylitis (tennis elbow) • 4 sites • 1)ECRL on supra-condylar ridge • 2)CEO • 3)Body of tendon • 4)belly of muscle

  17. Tennis Elbow Treatments • 1)ECRL – friction and rest • (forearm in supination) • Frictions must be specific and transverse • Chronic – numbness + 10 mins

  18. Tennis Elbow Treatments • 2)CEO Injec and rest or friction, mills manip, stretch and rest (forearm in supination)

  19. Tennis Elbow Treatments • 2) CEO cont • 3)Body of tendon - injec and rest or friction and rest (forearm in pronation) • 4)Belly of muscle – injec and rest and frictions (forearm in mid position)

  20. Tennis Elbow Other Treatments • Advice • Must adjust technique or grip in sports • Stretches • Strapping • SSTM/ muscle energy techniques • Acupuncture

  21. Medial Epicondylitis (golfer’s elbow) • 2 sites • 1)CFO • 2)MT junction

  22. Golfer’s Elbow cont • Overuse • Pain on resisted wrist flexion with elb ext

  23. Golfer’s Elbow Treatments • 1)CFO – injec and rest or friction and rest • 2)MT junction – friction and rest

  24. Biciptal Tendonitis • Overuse • Pain on resisted elbow flexion with supin • Treatment – MT junc friction and rest

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