Skip to Main Content

++

A 43-year-old female patient presents with complaints of left elbow pain which she reported having for about a year. The patient described the onset of elbow pain as gradual and attributed it to her previous work as an electronics assembler, where she spent the day pulling out plugs. Over time the pain had worsened to the point where it hurt all of the time. Although the patient had tried a course of anti-inflammatories, they had been discontinued due to an adverse reaction. The patient has since been placed on light duty at work with a lifting restriction of 10 lb. The patient reported no previous history of elbow pain and her past medical and surgical history were unremarkable.

++
++
++

What is the most common diagnosis characterized by lateral elbow pain?

++
++

The most common diagnosis characterized by lateral elbow pain is lateral epicondylitis.

++
++

What does a history of gradual onset of an injury typically indicate?

++
++

A gradual onset of symptoms is typically indicative of an overuse injury.

++
++

Which vocations or avocations are commonly associated with lateral epicondylitis?

++
++

The following vocations or avocations are commonly associated with lateral epicondylitis: tennis, racquetball, golf, carpentry, gardening, and needlework.

++
++

What factors contribute to lateral epicondylitis in tennis players?

++
++

The following factors contribute to lateral epicondylitis in tennis players: increased racquet stiffness, improperly sized racquet grip, heavy tennis balls, small racquet size, and high string tension.

++
++

What is your differential diagnosis?

++
++

The differential for lateral epicondylitis includes, but is not limited to, cervical spine disease, radiohumeral joint inflammation, and radial tunnel syndrome.

++
++

What is radial tunnel syndrome and how is it associated with tennis elbow?

++
++

Radial tunnel syndrome (RTS) involves compression of the radial nerve by the fibrous edge of the origin of the extensor carpi radialis brevis. RTS symptoms often mimic those of lateral epicondylitis.

++
++

Does this presentation and history warrant an upper quarter screening examination? Why or why not?

++
++

Based on the classic history, and a fairly clear mechanism of injury, this patient would not warrant an upper quarter screening examination.

++

The physical examination should include an inspection for muscle atrophy, palpation for areas of tenderness and crepitation, muscle testing of all major muscles about the elbow, measurement of active and passive range of motion, observation of symmetry of carrying angle, and specific testing for tennis elbow and instability. The cervical spine and shoulder should also be examined and ruled out. The only positive findings from this patient were as follows:

+...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessPhysiotherapy Full Site: One-Year Subscription

Connect to the full suite of AccessPhysiotherapy content and resources including interactive NPTE review, more than 500 videos, Anatomy & Physiology Revealed, 20+ leading textbooks, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPhysiotherapy

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.