Elbow pain

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editors-In-Chief: Jumana Nagarwala, M.D., Senior Staff Physician, Department of Emergency Medicine, Henry Ford Hospital and Cafer Zorkun, M.D., Ph.D. [2]

Overview

Elbow is comprised of the radius, ulna, and distal humerus. Trauma is the most common cause of elbow pain. The elbow is the third most commonly dislocated large joint

Causes

Common Causes

• Dislocation
• Fracture
• Golfer's elbow
• Nursemaid's elbow
• Tennis elbow

Causes by Organ System

Cardiovascular	Lymphadenitis, Thoracic aortic aneurysm, Thoracic outlet syndrome, Venous Insufficiency
Chemical/Poisoning	No underlying causes
Dental	No underlying causes
Dermatologic	Henoch-Schonlein purpura, Wegener's granulomatosis
Drug Side Effect	No underlying causes
Ear Nose Throat	Wegener's granulomatosis
Endocrine	No underlying causes
Environmental	No underlying causes
Gastroenterologic	No underlying causes
Genetic	Aagenaes syndrome, Noonan syndrome, Spondyloepiphyseal dysplasia tarda, Multiple epiphyseal dysplasia
Hematologic	Henoch-Schonlein purpura, Venous Thrombosis
Iatrogenic	Acupuncture, Hemodialysis, Venipuncture
Infectious Disease	Acute rheumatic fever, Cellulitis, Gonorrhea, Henoch-Schonlein purpura, Infection, Rheumatic fever, Septic arthritis
Musculoskeletal/Orthopedic	Arthritis, Bone fragments in elbow, Bone tumor, Brachioradial pruritis, Broken elbow, Bursitis, Cervical radiculopathy, Cubital tunnel syndrome, Dislocation, Distal radius fracture, Elbow injury, Elbow sprain, Enthesitis, Epicondylitis, Fracture, Golfer's elbow, Hemarthrosis, Lateral epicondylitis, Lateral synovial plica, Ligamentous injury, Little league elbow, Muscle sprain, Myofascial pain, Nursemaid's elbow, Olecranon bursitis, Osteoarthritis, Osteochondral defect, Osteochondritis, Osteochondritis dissecans, Osteochondrosis, Osteosarcoma, Posterior osteophytes, Pseudogout, Pulled elbow, Radial tunnel syndrome, Repetitive strain injury, Rotator cuff tear, Subacromial bursitis, Synovial chondromatosis, Synovial osteochondromatosis, Tendinitis, Tendon sprain, Tendonitis, Tennis elbow, Thrower's elbow, Trochleitis, Ulnar collateral ligament injury, Ulnar collateral ligament insufficiency, Valgus extension overload
Neurologic	Cervical radiculopathy, Nerve entrapment, Referred pain due to cervical nerve root irritation, Spinal cord injury, Ulnar nerve entrapment, Ulnar neuritis, Wegener's granulomatosis
Nutritional/Metabolic	No underlying causes
Obstetric/Gynecologic	No underlying causes
Oncologic	Bone tumor, Osteosarcoma
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal/Electrolyte	Hemodialysis, Henoch-Schonlein purpura, Wegener's granulomatosis
Rheumatology/Immunology/Allergy	Acute rheumatic fever, Common variable immunodeficiency, Felty Syndrome, Gout, Juvenile dermatomyositis, Juvenile rheumatoid arthritis, Pseudogout, Psoriatic arthritis, Rheumatoid arthritis, Rheumatic fever, Wegener's granulomatosis
Sexual	No underlying causes
Trauma	Amputation, Broken elbow, Dislocation, Distal radius fracture, Elbow injury, Elbow sprain, Fracture, Ligamentous injury, Muscle sprain, Myofascial pain, Nursemaid's elbow, Rotator cuff tear, Tendon sprain, Ulnar collateral ligament injury, Ulnar collateral ligament insufficiency
Urologic	No underlying causes
Miscellaneous	Artificial limb, Dysbarism

Causes in Alphabetical Order

Aagenaes syndrome Acupuncture Acute rheumatic fever Amputation Arthritis Artificial limb Bone fragments in elbow Bone tumor Brachioradial pruritis Broken elbow Bursitis Cellulitis Cervical radiculopathy Common variable immunodeficiency Cubital tunnel syndrome Dislocation Distal radius fracture Dysbarism Elbow injury Elbow sprain Enthesitis Epicondylitis Felty Syndrome Fracture Golfer's elbow Gonorrhea Gout Hemarthrosis

Hemodialysis Henoch-Schonlein purpura Infection Juvenile dermatomyositis Juvenile rheumatoid arthritis Lateral epicondylitis Lateral synovial plica Ligamentous injury Little league elbow Lymphadenitis Multiple epiphyseal dysplasia Muscle sprain Myofascial pain Nerve entrapment Noonan syndrome Nursemaid's elbow Olecranon bursitis Osteoarthritis Osteochondral defect Osteochondritis dissecans Osteochondritis Osteochondrosis Osteosarcoma Posterior osteophytes Pseudogout Psoriatic arthritis Pulled elbow Radial tunnel syndrome

Referred pain due to cervical nerve root irritation Repetitive strain injury Rheumatic fever Rheumatoid arthritis Rotator cuff tear Septic arthritis Spinal cord injury Spondyloepiphyseal dysplasia tarda Subacromial bursitis Synovial chondromatosis Synovial osteochondromatosis Tendinitis Tendon sprain Tendonitis Tennis elbow Thoracic Aortic Aneurysm Thoracic outlet syndrome Thrower's elbow Trochleitis Ulnar collateral ligament injury Ulnar collateral ligament insufficiency Ulnar nerve entrapment Ulnar neuritis Valgus extension overload Venipuncture Venous Insufficiency Venous Thrombosis Wegener's granulomatosis Differentiating Elbow Pain from other Conditions In alphabetical order. Angina Bursitis Dislocation Distal biceps tendon rupture Epicondylitis Fracture Gouty arthritis Infection Loose body Osteoarthritis Pronator Syndrome Radial Tunnel Syndrome Rheumatoid Arthritis Trauma Ulnar nerve entrapment Diagnosis Physical Examination Careful examination of hand, wrist, elbow and shoulder Electrocardiogram Should be performed in a patient with risk factors for coronary heart disease. X-Ray Standard X-rays (anterior/posterior, lateral and oblique views) MRI Rarely, MRI may be indicated. Other Diagnostic Studies Aspiration Nerve conduction tests Treatment Elevation, immobilization (elbow flexed at 90 degrees), analgesia for fracture management Anatomic reduction (neurovascular compromise) Rest and physical therapy (epicondylitis) Reduction (elbow dislocation, nursemaid's elbow) Pharmacotherapy Acute Pharmacotherapies Nonsteriodal anti-inflammatory drugs (NSAIDs) (general fracture, epicondylitis) References Template:WikiDoc Sources