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

Differential Diagnosis

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

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 and CT

• 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

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