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Tennis elbow, also known as lateral epicondylitis is an enthesopathy (attachment point disease) of the origin of the extensor carpi radialis brevis on the lateral epicondyle. [1] [5] It causes pain and tenderness over the bony part of the lateral epicondyle. Symptoms range from mild tenderness to severe, persistent pain.
The tests differ in the rotation of the arm; in the empty can test, the arm is rotated to full internal rotation (thumb down) and in the full can test, the arm is rotated to 45° external rotation, thumb up. [1] Once rotated, the clinician pushes down on either the wrists or the elbow, and the patient is instructed to resist the downward pressure.
A common injury associated with the lateral epicondyle of the humerus is lateral epicondylitis also known as tennis elbow. Repetitive overuse of the forearm, as seen in tennis or other sports, can result in inflammation of "the tendons that join the forearm muscles on the outside of the elbow.
A common diagnostic test utilized for lateral epicondylitis is to assess resisted wrist extension, along with resistance to the middle finger. If symptoms can be reproduced, it could indicate lateral epicondylitis. [5] For medial epicondylitis, resisted wrist flexion and pronation would be assessed by your provider.
Jobe's test is a physical exam test that is used to detect anterior shoulder instability. It is used to distinguish between anterior instability and primary shoulder impingement. This test should be performed after the Apprehension test. [3] This test was named for Christopher Jobe. [4]
The Apley scratch test specifically tests range of motion and in a normal exam, an individual should be able to reach C7 on external rotation, and T7 on internal rotation. Evaluation of distal pulses; Strength testing: wrist extension tests the radial nerve, finger abduction tests the ulnar nerve, and thumb apposition tests the median nerve.
Lateral elbow pain can be caused by various pathologies of the common extensor tendon. [3] Overuse injuries can lead to inflammation . [ 4 ] [ 5 ] Tennis elbow is a common issue with the common extensor tendon.
The patient is asked to either sit on an examination table or stand while performing this test. Examiner should be standing on the patient's lateral side or behind the arm being evaluated. Examiner will passively abduct the patient's shoulder (humerus) to 90 degrees. The patient is then asked to slowly lower or adduct the shoulder to their side.