PATIENT EVALUATION

A.     Subjective:

•    Patient complaint

•    Location

•    Onset and duration of symptoms - have patient demonstrate the mechanism of injury on the non-involved side

•    Description of symptoms (i.e.. numbness. pain [constant, dull, sharp] hypersensitivity. stiffness); use pain scale

•    Pattern of when symptoms occur (AM. PM. after activity, etc.)

•    Self-help or other formal treatment

•    Other medical problems

•    Concurrent medications and allergies

B.     Objective (also compare with uninvolved elbow):

1.  Inspection:

•    Carrying angle, arm posturing

•    Redness, swelling, warmth

•    Scars

2. Palpation:

•    Bony lateral epicondyle. medial epicondyle. olecranon, olecranon fossa, radial head, ulnar head - check for calcified nodules

•    Soft tissue: muscles and tendons (laterally. anteriorly, medially, posteriorly)

•    Olecranon - (posteriorly) if "boggy" and/or thick then bursa is inflamed

3. Mobility:

•  Active and passive ROM (flexion, extension.
supination, pronation)

4. Muscle Testing:

•  Wrist extensors and flexors, supinators.
pronators, elbow flexors and extensors

5. Provocation Tests:

•  Rule out muscle, tendon and capsular involve­
ment

6. Neurological:

•  Reflexes, sensation

7. Other joints:

•  Test neck, shoulder, wrist and hand for second­
ary involvement

8. Review x-ray films and physician's report

C.     Assessment:

1. Problem list

2.    Goals

3.    Treatment:

•    Iontophoresis (medications, dosages, electrode size)

•    Other modalities (e.g.. ice or heat, electrical stimulation, stretching, strengthening, home program, activity or sport re-education for prevention of re-injury, etc.)

•    Oral or injectable medications (administered by physician, e.g.. NSAIDs. corticosteroids)

D.     Plan:

1. Frequency and duration of treatment

2.    Dates for assessment of progress

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