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Elbow History
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Contents
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, Neuro-myofascial )
- Synovitis of the radiohumeral joint
- Radiohumeral bursitis
- Posterior interosseous nerve entrapment or radial tunnel syndrome
- Osteochondritis dissecans (Capitellum, Radius in adolescents )
- Posterolateral rotatory instability
Medial Elbow Pain
- Medial Elbow Tendinopathy
- Medial collateral ligament sprain (acute and chronic)
- Ulnar neuritis
- Avulsion fracture of the medial epicondyle (children and adolescents)
- Apophysitis (children and adolescents)
- Referred pain
Posterior Elbow Pain
- Olecranon bursitis
- Triceps Tendinopathy
- Posterior impingement
- Gout
Anterior Elbow Pain
Generalised
- Osteoarthritis
- If locking consider chondromalacia, osteochondritis, loose bodies
