The Elbow

Palpation

• The patient sits, with the arm resting on het couch
• The elbow is held between flexion and extension (about 45° flexion) and in nearly full pronation. In this position the tendon overlies the head of the radius.
• The examiner sits next to the patient, takes hold of the patient's elbow with his contralateral hand and palpates with the thumb at the lateral aspect of the elbow. The other hand keeps the arm pronated.
• The lateral epicondyle is easily found. Also the head and the neck of the radius can be palpated.
• The thumb is then brought forwards and medially. Starting from medially, the thumb is now pulled towards the examiner.
• At nearly the end of the movement, one feels a round and dense structure slipping under palpating thumb.
• This is the tendon of the extensor carpi radialis brevis.
• This structure is always tender to the touch. Therefore, always compare tenderness on both sides.