Elbow Examination


  • Wash hands, introduce self, check patient name and DOB/CHI, explain procedure and gain consent


  • Inspect the elbow in full extension (normally the elbow has 10-13° of valgus deviation in extension- the carrying angle)
    • Bruising, scars, swelling, redness, tophi, nodules.  Muscle wasting


  • The lateral and medial epicondyles and olecranon (these make roughly an equilateral triangle in elbow flexion at 90°)
    • Is there any sponginess/tenderness
      • synovitis is boggy/spongy around the olecranon in extension
      • tenderness of the lateral or medial epicondyles may indicate tennis or golfers elbow, respectively (epicondylitis)
  • Also palpate the flexor and extensor tendons for associated tenderness of epicondylitis


  • Assess felxion/extension (touch elbow and straighten arm)
    • Normally 0-145°; anything less than 30-110° can cause functional problems
  • Assess supination and pronation of the forearm

Tennis Elbow

If you suspect lateral epicondylitis:

  • With the elbow at right angles and hand in pronation, and you supporting the elbow, ask the patient to extend their wrist against resistance.
    • If this is painful at the lateral epicondyle/extensor surface of the forearm, this suggests the diagnosis

Golfer’s elbow

If you suspect golfer’s elbow:

  • With the elbow at right angles and hand in supination, and you supporting the elbow, ask the patient to flex the wrist against resistance.
    • If painful at the medial epicondyle/flexor surface of the arm, the test supports the diagnosis.

Other special tests

  • Medial and lateral collateral ligaments: with the elbow flexed at 30°, apply varus (lateral collateral- best tested whilst supinated) and valgus (medial collateral- best tested when pronated) forces


  • Thank patient, wash hands and report/document findings with any suggestions about further tests/management

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