Orthopedic Pathologies of the elbow

Differential Diagnosis	Signs and Symptoms
Radial Head Fx	P outside elbow, swelling elbow jt, difficulty flex/ext elbow and pronate/sup, limited ROM, tenderness over radial head, nerve irratation posible
Common Flexor Tendon /Common Extensor Tendon Stain	unable to bend one or more jts in fingers, P when flexing fingers, if cut; on the palm side near skin folds, mild swelling, tenderness in palmer side
Overuse/Tendonitis	P!, tenderness, mild swelling
Radial Nerve Injury	numbness/tingling/P! back arm/forearm/hand, mm weakness in ext elbow/wrist/fingers, atrophy
Anterior Dislocation	deformity, swelling, loss function/ROM, elbow fixed ext, cubital fossa full with condyles of humerus
Posterior Dislocation	Deformity, swelling, loss function/ROM, fixed in flexion, profuse hemorage
Olecranon Bursitis	P! around olecranon, swelling directly over same point, limited ROM, localized heat if infected
MCL/LCL/Annular Ligament Sprains	swelling anterior/medial/posterior, anterior oblique band most common injured, elbow flex past 60 posterior band, decreased ROM, laxity w/ valgus, P! w/ ROM, loss function, tenderness, hemorage, ecchymosis
Osteochondritis Dissecans	P after exercise, loss of function, chronic swelling, atrophy, crepitus, transient locking
Olecranon Fracture	intense P, bruising @ elbow, rupture/abrasion overlying skin, deformity, tenderness/swelling over bone, numbness in fingers, P with ROM
Epiphyseal Fracture	fracture of growth plate, Salter-Harris classification, may result in abnormal growth of bone ends, deformity, swelling, pt tenderness, guarding, bruising, crepitus, P!, locked jt
Ulnar Nerve Contusion/Dislocation	stabbing P, loss sensation, paralysis, mm atrophy, defective reflexes, abnormal sensations 4th/5th and palmer on ulnar side, spasms/cramping 4th/5th, aching in medial elbow w/ radiating P, loss pinch strength, + tinnels, wartenberg, elbow flex test
Median Nerve Injury	loss strength, loss ROM in 2nd/3rd fingers, paralyzed mm's, ape thumb deformity, opponens palsy, inablity flex IP jt in thumb, decreased sensation, tingling/burning, unable to grasp
Volkman’s Ischemic Contracture (Acute Compartment Syndrome)	trauma, extreme P with ext mm's, burning/prickling sensations, necrosis ext. mm's, claw hand, loss sensory/motor function, edema, ulnar/median nerve palsy
Tennis Elbow (Lateral Epicondylitis)	severe burning P lateral eblow, gradually increases, P radiates to forearm, dificulty carrying objects, P w/ wrist ext, dominant arm, difficulty pinching, weak/P grip, pt tenderness
Little League Elbow (Medial Epicondylitis	swelling/soreness, P throwing/movement/sharp/dull/achy, pt tenderness, stiff elbow/decreased ROM, hand/wrist weakness, burning sensation medial epicondyle
Supracondylar Fracture	P elbow, swelling, unable to move from P, decreased ROM, maybe vascular/neuro problems, shortened arm, open wound, high-energy trauma/significant fall

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