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Elbow History
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Introduction
Duration of illness
Acute or chronic
Circumstances of onset
Trauma (direct / indirect), repetitive overload, or spontaneous onset.
Mode of Onset
Are there red flags? Was the onset insidious?
Radiation
Does it radiate along compartment to the wrist.
Quality
Is it deep, dull, aching. Is there dysaethesia. Is it sharp or shooting.
Frequency
Is it related to activity.
Time of Onset
Does it come on during the day or night.
Precipitating and Aggravating Factors
Is it related to gripping / pinching, flexion of the elbow, supination, pronation. Is there pain and stiffness after rest. Is there locking.
Relieving Factors
Do certain positions or activities relieve it.
Associated features
Is there fever, weight loss, malaise.
Differential Diagnoses
Lateral Elbow Pain
- Lateral Elbow Tendinopathy
- Referred pain (Cervical spine, Upper thoracic spine, Myofascial)
- Synovitis of the radiohumeral joint
- Radiohumeral bursitis
- Radial Head Fractures
- Radial Head Dislocation
- Capitellar Osteochondritis Dissecans (Capitellum, Radius in adolescents)
- Capitellar Osteochondrosis
- Lateral Condyle Fracture
- Capitellum Fracture
- Lateral Collateral Ligament Complex Injury
- Radial Head Subluxation (Nursemaid Elbow)
- Radiocapitellar Osteoarthrosis
- Bone Neoplasm
- Soft Tissue Neoplasm
- Posterolateral Rotary Instability
- Posterior Interosseous Nerve Entrapment or Radial Neuropathy at the Spiral Groove
- Posterolateral Plica Syndrome
Medial Elbow Pain
- Medial Elbow Tendinopathy
- Medial collateral ligament injury (acute and chronic)
- Ulnar neuritis
- Avulsion fracture of the medial epicondyle (children and adolescents)
- Apophysitis (children and adolescents)
- Referred pain (Cervical Radicular Pain, somatic referred myofascial pain)
- Myofascial pain
- Ulnar Neuropathy
- Little Leaguer's Elbow
- Triceps Tendinopathy and rupture
- Fractures (Olecranon Fracture, Pediatric Medial Epicondyle Avulsion, Coronoid Process Fracture, Medial Condyle Fracture)
- Medial epitrochlear lymphadenopathy (e.g. from cat-scratch disease)
- Anconeus Epitrochlearis
- Cyst, Mass, Foreign Body
Posterior Elbow Pain
- Olecranon bursitis
- Triceps Tendinopathy
- Posterior impingement
- Gout
Anterior Elbow Pain
Generalised
- Osteoarthritis
- If locking consider chondromalacia, osteochondritis, loose bodies
