Careful inspection of the elbow joint and surrounding areas is the next step in evaluating elbow injury. First, the examiner should note atrophy or hypertrophy of muscle groups of the arm or forearm and should obtain girth measurements. Hypertrophy of the forearm musculature often is present in the dominant extremity of the throwing athlete and should be considered a normal variant. Atrophy of arm and forearm musculature, however, might result from an underlying neurologic disorder.
Second, the examiner should measure the carrying angle of the elbow with the arm extended and forearm supinated (Fig. 3.1). The normal carrying angle is 11° in men and 13° in women.9 An increase in the carrying angle is termed cubitus valgus. Often, this angle increases from 10° to 15° in throwing athletes due to adaptive remodeling from repetitive valgus bony stress.8,10 A progressive cubitus valgus deformity also might result from a nonunited lateral condyle fracture and might lead to a tardy ulnar nerve palsy.11 A decrease in the carrying angle is termed cubitus varus. Cubitus varus might result from a malunited supracondylar humeral fracture or a previous growth plate disturbance due to trauma or inflammation.
Third, the clinician should examine the elbow for swelling. Swelling over the olecranon can indicate ole-cranon bursitis from trauma or underlying inflammation. Swelling in the area of the lateral soft spot (i.e., an area located in the center of the triangle formed by the lines connecting the olecranon, lateral epicondyle, and radial head) might result from a joint effusion or synovial proliferation due to trauma, infection, or rheumatologic disorder (Fig. 3.2). The clinician should carefully examine the skin in these areas for erythema, which can indicate an infection.
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Everything you wanted to know about. How To Cure Tennis Elbow. Are you an athlete who suffers from tennis elbow? Contrary to popular opinion, most people who suffer from tennis elbow do not even play tennis. They get this condition, which is a torn tendon in the elbow, from the strain of using the same motions with the arm, repeatedly. If you have tennis elbow, you understand how the pain can disrupt your day.