Ewha Med J.  2023 Oct;46(4):e13. 10.12771/emj.2023.e13.

Differential Diagnosis of Elbow Pain

• Chung HJ
• Joo YB
• Park JY
• Lee WY

• KMID: 2547917
• DOI: http://doi.org/10.12771/emj.2023.e13

Abstract

Elbow pain is a common symptom encountered in clinical practice. Pathology can arise from any component of the joint, including the bone, tendons, ligament, bursa, or nerves. This paper discusses how elbow pain can be differentiated according to its anatomic location and presents the corresponding causes, diagnosis, and treatment options.

Keyword

Elbow pain; Diagnosis, differential; Anatomic location

Reference

References

1. Kane SF, Lynch JH, Taylor JC. Evaluation of elbow pain in adults. Am Fam Phys. 2014; 89((8)):649–657.

2. Colasanti CA, Boin M, Hacquebord J, Virk M. Anterior interosseous nerve palsy in the early postoperative period after open capsular release for elbow stiffness. Clin Shoulder Elb. 2022; Nov. 21. [Epub]. DOI: 10.5397/cise.2022.00899. PMID: 37088884.

3. Kang B, Jung GH, Kholinne E, Jeon IH, Kwak JM. The elbow is the load-bearing joint during arm swing. Clin Shoulder Elb. 2023; 26((2)):126–130. DOI: 10.5397/cise.2023.00101. PMID: 37316173. PMCID: PMC10277704.

4. Goodfellow JW, Bullough PG. The pattern of ageing of the articular cartilage of the elbow joint. J Bone Joint Surg Br. 1967; 49((1)):175–181. DOI: 10.1302/0301-620X.49B1.175.

5. Halls AA, Travill A. Transmission of pressures across the elbow joint. Anat Rec. 1964; 150((3)):243–247. DOI: 10.1002/ar.1091500305. PMID: 14227963.

6. Shin W, Kang T, Han J. Cubital tunnel syndrome associated with previous ganglion cyst excision in the elbow: a case report. Clin Shoulder Elb. 2022; Nov. 21. [Epub]. DOI: 10.5397/cise.2022.01102.

7. Annaniemi JA, Pere J, Giordano S. Platelet-rich plasma versus corticosteroid injections for rotator cuff tendinopathy: a comparative study with up to 18-month follow-up. Clin Shoulder Elb. 2022; 25((1)):28–35. DOI: 10.5397/cise.2021.00486. PMID: 35086189. PMCID: PMC8907507.

8. Kashiwagi D. Intraarticular changes of the osteoarthritic elbow, especially about the fossa olecrani. J Jph Orthop Assoc. 1978; 52:1367–1368.

9. Rajani AM, Mittal ARS, Kulkarni V, Rajani K, Rajani K. Role of concomitant percutaneous pie crusting and local corticosteroid injection in lateral epicondylitis: a prospective, case control study. Clin Shoulder Elb. 2023; 26((1)):49–54. DOI: 10.5397/cise.2022.01375. PMID: 36919507. PMCID: PMC10030988.

10. Shim BJ, Seo EM, Hwang JT, Kim DY, Yang JS, Seo SJ, et al. Comparison of the effectiveness of extensor muscle strengthening exercise by itself, exercise with polydeoxyribonucleotide injection, and exercise with extracorporeal shockwave therapy in lateral epicondylitis: a randomized controlled trial. Clin Shoulder Elb. 2021; 24((4)):231–238. DOI: 10.5397/cise.2021.00290. PMID: 34823312. PMCID: PMC8651591.

11. Barman A, Mishra A, Maiti R, Sahoo J, Thakur KB, Sasidharan SK. Can platelet-rich plasma injections provide better pain relief and functional outcomes in persons with common shoulder diseases: a meta-analysis of randomized controlled trials. Clin Shoulder Elb. 2022; 25((1)):73–89. DOI: 10.5397/cise.2021.00353. PMID: 34823313. PMCID: PMC8907495.

12. Braaksma C, Otte J, Wessel RN, Wolterbeek N. Investigation of the efficacy and safety of ultrasound-standardized autologous blood injection as treatment for lateral epicondylitis. Clin Shoulder Elb. 2022; 25((1)):57–64. DOI: 10.5397/cise.2021.00339. PMID: 35045598. PMCID: PMC8907499.

13. Bisset L, Paungmali A, Vicenzino B, Beller E. A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia. Br J Sports Med. 2005; 39((7)):411–422. DOI: 10.1136/bjsm.2004.016170. PMID: 15976161. PMCID: PMC1725258.

14. Morrey BF, Tanaka S, An KN. Valgus stability of the elbow: a definition of primary and secondary constraints. Clin Orthop Relat Res. 1991; ((265)):187–195. DOI: 10.1097/00003086-199104000-00021.

15. Jones KJ, Osbahr DC, Schrumpf MA, Dines JS, Altchek DW. Ulnar collateral ligament reconstruction in throwing athletes: a review of current concepts: AAOS exhibit selection. J Bone Joint Surg. 2012; 94((8)):e49. DOI: 10.2106/JBJS.K.01034. PMID: 22517395.

16. Cain EL, Andrews JR, Dugas JR, Wilk KE, McMichael CS, Walter JC, et al. Outcome of ulnar collateral ligament reconstruction of the elbow in 1281 athletes: results in 743 athletes with minimum 2-year follow-up. Am J Sports Med. 2010; 38((12)):2426–2434. DOI: 10.1177/0363546510378100. PMID: 20929932.

17. Rijke AM, Goitz HT, McCue FC, Andrews JR, Berr SS. Stress radiography of the medial elbow ligaments. Radiology. 1994; 191((1)):213–216. DOI: 10.1148/radiology.191.1.8134574. PMID: 8134574.

18. Ellenbecker TS, Mattalino AJ, Elam EA, Caplinger RA. Medial elbow joint laxity in professional baseball pitchers. Am J Sports Med. 1998; 26((3)):420–424. DOI: 10.1177/03635465980260031301. PMID: 9617406.

19. Schwartz ML, al-Zahrani S, Morwessel RM, Andrews JR. Ulnar collateral ligament injury in the throwing athlete: evaluation with saline-enhanced MR arthrography. Radiology. 1995; 197((1)):297–299. DOI: 10.1148/radiology.197.1.7568841. PMID: 7568841.

20. Bruce JR, Andrews JR. Ulnar collateral ligament injuries in the throwing athlete. J Am Acad Orthop Surg. 2014; 22((5)):315–325. DOI: 10.5435/JAAOS-22-05-315. PMID: 24788447.

21. Barman A, Mukherjee S, Sinha MK, Sahoo J, Viswanath A. The benefit of platelet-rich plasma injection over institution-based physical therapy program in adhesive capsulitis patients with diabetes mellitus: prospective observational cohort study. Clin Shoulder Elb. 2021; 24((4)):215–223. DOI: 10.5397/cise.2021.00381. PMID: 34781602. PMCID: PMC8651589.

22. Dugas J, Chronister J, Cain EL Jr, Andrews JR. Ulnar collateral ligament in the overhead athlete: a current review. Sports Med Arthrosc Rev. 2014; 22((3)):169–182. DOI: 10.1097/JSA.0000000000000033. PMID: 25077747.

23. Morrow RM, McIlvian GE, Johnson J, Timmons MK. Youth throwing athletes do not show bilateral differences in medial elbow width or flexor tendon thickness. Clin Shoulder Elb. 2022; 25((3)):188–194. DOI: 10.5397/cise.2022.00766. PMID: 35791681. PMCID: PMC9471821.

24. Arvind CH, Hargreaves DG. top relocation test: a new clinical test for posterolateral rotatory instability of the elbow. J Shoulder Elb Surg. 2006; 15((6)):707–708. DOI: 10.1016/j.jse.2006.01.005. PMID: 17126242.

25. Regan W, Lapner PC. Prospective evaluation of two diagnostic apprehension signs for posterolateral instability of the elbow. J Shoulder Elb Surg. 2006; 15((3)):344–346. DOI: 10.1016/j.jse.2005.03.009. PMID: 16679236.

26. O'Driscoll SW, Bell DF, Morrey BF. Posterolateral rotatory instability of the elbow. J Bone Joint Surg. 1991; 73((3)):440–446. DOI: 10.2106/00004623-199173030-00015. PMID: 2002081.

27. Anakwenze OA, Kancherla VK, Iyengar J, Ahmad CS, Levine WN. Posterolateral rotatory instability of the elbow. Am J Sports Med. 2014; 42((2)):485–491. DOI: 10.1177/0363546513494579. PMID: 23845400.

28. Hutchinson MR, Ireland ML. Overuse and throwing injuries in the skeletally immature athlete. J Am Acad Orthop Surg. 2003; 52:25–36.

29. Peterson RK, Savoie FH 3rd, Field LD. Osteochondritis dissecans of the elbow. Instr Course Lect. 1999; 48:393–398.

30. Aaron DL, Patel A, Kayiaros S, Calfee R. Four common types of bursitis: diagnosis and management. J Am Acad Orthop Surg. 2011; 19((6)):359–367. DOI: 10.5435/00124635-201106000-00006. PMID: 21628647.

31. Herrera FA, Meals RA. Chronic olecranon bursitis. J Hand Surg. 2011; 36((4)):708–709. DOI: 10.1016/j.jhsa.2010.12.030. PMID: 21411239.

32. Torralba KD, Quismorio FP Jr. Soft tissue infections. Rheum Dis Clin. 2009; 35:45–62. DOI: 10.1016/j.rdc.2009.03.002. PMID: 19480996.

33. van Riet RP, Morrey BF, Ho E, O'Driscoll SW. Surgical treatment of distal triceps ruptures. J Bone Joint Surg. 2003; 85((10)):1961–1967. DOI: 10.2106/00004623-200310000-00015. PMID: 14563805.

34. Bach BR Jr, Warren RF, Wickiewicz TL. Triceps rupture: a case report and literature review. Am J Sports Med. 1987; 15((3)):285–289. DOI: 10.1177/036354658701500319. PMID: 3618881.