The elbow examination is an important clinical exam to be comfortable with. Although it doesn't crop up as commonly as the shoulder/hip examinations in OSCEs, it is an important one to master especially if you will be working in A&E or GP setting. The examination follows the usual 'Look, Feel and Move' structure but it is important that you are aware of certain conditions that can manifest with abnormalities in the elbow. Examples of this are seen in psoriatic arthropathy, rheumatoid arthritis, septic arthritis and olecranon bursitis.
“Hi, my name is Rick Deckard and I am a 4th year medical student”
Check patient details
“I have been asked to examine your elbow today. This involves having a look, a feel and asking you to do a few exercises.”
Gain verbal consent
“Would this be ok with you?”
NB: Remember to talk to the patient during the examination to put them at ease.
"To begin with I'll just be having a look at your elbow for any scars, swelling or changes."
Inspect from the front
Inspect from the side
Inspect from the back
NB: Before starting, ask the patients if they have any pain in the elbow. Then proceed and ask them to let you know if it causes any discomfort
"I'll just move on to have a feel of your elbow, please let me know if this causes you any discomfort"
NB: Ask the patient to start with making these movements actively (they move it themselves) then move on to passively (you move them for the patient)
Assess each of the movements of the elbow joint actively and passively:
NB: While moving the elbow passively, feel for crepitus
Lateral epicondylitis (Tennis Elbow) Test
“I will be asking you to move your wrist up against my hand. Let me know if you feel any pain”
A positive test would cause pain over the lateral epicondyle region
Medial epicondylitis (Golfer's Elbow) Test
A positive test would cause discomfort along the medial part of the elbow over the medial epicondyle region.
“That’s the end of the exam. Thank you for your time. Would you like any help getting dressed?”
Summarise your findings and state other exams for completion
“Today I have seen Joe Blogs...To complete the examination I would examine the shoulder and the wrist joints as well as conducting a full upper limb neurological assessment.”
State what investigations you would perform