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