Question

A patient presents complaining of weakness and mild pain at the right (R) elbow on the lateral side. The pain is limiting functional activity, in particular activities that involve gripping and turning.

a) Considering the types of skills and the specific tests for elbow structures, outline how you would go about differentiating the contribution of the elbow joints and the relevant muscles to causing this impairment, indicating which tests you could use and what information you would gain from performing them.

b) In relation to the pain with gripping experienced by this patient, list the two (2) types of prehension and for each give examples and descriptions of two (2) different grips.

Answer 1

a) Since, lateral part of the elbow has presenting features like mild pain amd weakness, then injury to extensor carpiradialis brevis is suspected, as it is the elbow muscle involved in gripping and lifting also.

A .series of tests such as Mill's test and cozen's test is applied to rule out the cause.

b) two types of prehensipn are-

Cylindrical grasp or spherical grasp.

And lateral prehension.

In cozen's test, patient is asked to sit, and his elbow is flexed to 90° , his forearm is pronated and asks fist to dorsiflex.

Examiner then stabilizes and resist the patient's dorsiflexion.

The test is positive when pain is present in the lateral elbow while resistance in action.

This suggests lateral epicodylitis or tennis elbow.

Another test is Mill's test, The patient isade to sit amd is instructed to extend the forearm, make a fist, and flex the wrist, and then maximally pronate the forearm. This test can be passively performed by the doctor.

Test is positive when pain in lateral elbow is present which suggests that it is lateral epicodylitis.

b) two types of prehension affected are-

Cylindrical prehension

Examply- cycling and riding motorcycle.

Palmar prehension-

Example- holding small objects, utensils.