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


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

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Differentiating Elbow Pain from other Conditions

In alphabetical order. [1] [2]

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

References

  1. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X


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