Orthopedic Pathologies of the elbow

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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