An evaluation of the elbow includes a physical examination and sometimes arthrocentesis (see How To Do Elbow Arthrocentesis).
(See also Evaluation of the Patient With Joint Symptoms.)
Physical Examination of the Elbow
Synovial swelling and thickening caused by joint disease occur in the lateral aspect between the radial head and olecranon, causing a bulge. Full 180° extension of the joint should be attempted. Although full extension is possible with nonarthritic or extra-articular problems such as tendinitis, its loss is an early change in arthritis. The area around the joint is examined for swellings. Rheumatoid nodules are firm, occurring especially along the extensor surface of the forearm. Tophi are palpable or sometimes visible under the skin as cream-colored aggregates and indicate gout. Nodules in the olecranon bursa may be either rheumatoid nodules or tophi. Swelling of the olecranon bursa occurs over the tip of the olecranon, is cystic, and does not limit joint motion; infection, trauma, gout, and rheumatoid arthritis are possible causes. Epitrochlear nodes occur above the medial epicondyle; they can result from inflammation in the hand but can also suggest sarcoidosis, syphilis, or lymphoma.
