Study Guide Questions: 8.

The questions for this week will focus on knowledge of orthopedic tests
and SMR assessment for the following conditions. Complete the table
below with the appropriate tests, clinical picture and SMR examination
findings. Hint: (Souza and Magee will be good texts to refer to answer
this question)

Lateral epicondylitis verses Medial Epicondylitis

Elbow Bursitis vs Elbow Tendinitis
Wrist fracture from a fall on an outstretched hand (FOOSH) vs Carpal
Tunnel Syndrome

Lateral Medial
Epicondyliti Epicondylit
s is
Test Cozen’s, Reverse
Clinic Mills Cozen’s
al
Pictur Extensor Flexor
e Tendinopat Tendinopa
SMR hy, from thy from
exam wrist wrist
Findin extension flexion and
gs against pronation
resistance against
with resistance
overuse. with
Grip overuse.
Strength Weakness,
affected. numbness,
tingling
along
ECRB medial
(Extensor aspect of
Carpi forearm
Radialis from ulnar
Brevis) will nerve
be weaker. entrapmen
t.

Elbow Elbow
Bursitis Tendinitis
 Observatio Resisted
n and flexion and
ultrasound supination
Inflammation of bursa from (radial
acute trauma or more tuberosity)
commonly chronic pressure
Resisted
due to its superficial
placement. Associated with
flexion
arthritis especially alone
rheumatoid (brachialis)
+ve pain
Tendernes
s in radial
tuberosity

Wrist Carpal
Fracture Tunnel
(FOOSH) Syndrome
injury Compressi
X-ray on of the
Distal median
radius and nerve as it
ulnar 10 passes
times more through
frequent the tunnel
than carpal formed by
bones. the carpal
Most often bones.
from falling Common
on overuse of
outstretche wrist
d hand. extension
or
vibrational
tools.

Cozen’s Test Lateral Epicondylitis – fully flex elbow, pronate and extend wrist.
Examiner puts pressure over direction of elbow extension with wrist
flexion. Pain or discomfort +ve
Mill’s Test Lateral Epicondylitis – extended elbow with pronation and flexion of
wrist – testing common extensor tendon. +ve lateral elbow pain
Froment’s Test Ulnar nerve paralysis – grasp a piece of paper between thumb and
index finger. +ve flexion of terminal phalanx due to paralysis of
adductor pollicis muscle

Lifting of object approx. 2.5 kg

Polk Lift Test Phase 1 – lateral epicondylitis (pronation of forearm)

Phase 2 medial epicondylitis (supination of forearm)

+ve is pain

Finkelstein’sTest De Quervain disease (paratenonitis of thumb). Fist with thumb inside

with ulnar deviation. +ve pain abductor pollicis longus and extensor
pollicis brevis.

TFCC Test Trauma to TFCC. Axial load and ulnar deviate wrist with palmar and
dorsal movements or rotation of forearm. +ve pain, crepitis in TFCC.

Phalen’s Test Carpal tunnel syndrome – maximally flexed wrists for 1min. +ve
tingling in thumb, index finger, and lateral half of ring finger

Bunnel Littler’s Metacarpalphalangeal joint – MTP is extended whilst

Test

Tinel’s Wrist Test Carpal Tunnel Syndrome – tapping of carpal and ulnar tunnel using
fingers or reflex hammer. +ve numbness, shooting electrical sensation
or pain and tingling in area

Kirk Watson Test Scaphoid stability and DJD of radio-scaphoid – anterior and posterior
movements of scaphoid. +ve pain, crepitis or laxity.

Test INTERPRETATION/WHAT TISSUE STRUCTURE DOES THIS TEST

LOAD? For you to complete