Elbow Pain In A Patient With Hypermobility - Page #1

Author: Michael Jones, DO
Co Author #1: Kathryn Vidlock MD
Senior Editor: Carolyn Landsberg, MD
Editor: Blake Corcoran, MD, CAQSM

Patient Presentation:
A 19-year-old female presented with a 2 year history of achy, right elbow pain. No known history of inciting trauma or injury.

Pain was located about the posterolateral aspect of the elbow. There were no alleviating factors. Lifting, carrying, or twisting with the arm aggravated her symptoms. She had associated right arm weakness, and recently began experiencing numbness and tingling of her right 4th and 5th digits. She reported her elbow felt as though something popped back and forth around the joint, resulting in the numbness, dozens of times daily. She denied joint instability, swelling, redness, ecchymosis, grinding, or history of trauma. She was also being evaluated for a hypermobility disorder due to laxity of the joints. She had undergone extensive physical therapy and used topical and oral NSAIDs without relief.

Physical Exam:
On examination, there was no erythema, ecchymosis, swelling, effusion or crepitus. Passive and active range of motion of the elbow joint and carrying angle were normal. Strength testing was also normal. Pain was reproduced with resisted wrist extension and supination. The patient's paresthesia of the 4th and 5th digits were reproduced by passive flexion and extension of the elbow, which also caused palpable subluxation of the right ulnar nerve.

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