Elbow Pain Without An Injury In A 13 Year Old Female Gymnast - Page #1

Author: Brian Hinkley, DO
Co Author #1: Brooke Lemmen, DO
Co Author #2: Andrew Schorfhaar

Patient Presentation:
A 13 year old female presented for a chief complaint of right elbow pain onset 8 weeks ago.

She states it has been ongoing for 8 weeks with no acute injury. Her pain is worse with full extension, especially with weight-bearing during gymnastics. She admits to occasional popping, but denies locking, instability, swelling or bruising. She has tried ice, NSAIDs and OMT with no significant relief. She denies any previous injuries or surgeries.

Physical Exam:
She is well-developed, well-nourished, and in no acute distress. Her right wrist exam is normal with no atrophy. Her right shoulder exam reveals normal appearance without reproducible tenderness to palpation. There is a palpable snap appreciated superior to her olecranon with extension. Her elbow strength is 4/5 with both flexion and extension. Valgus and varus stress testing are negative. Tinel's is negative over the ulnar nerve. Milking sign is negative. Her right shoulder exam is significant for 4/5 strength with internal rotation, external rotation, and abduction without reproduction of pain. A Spurling's test is normal. She has normal reflexes and sensation. Examination of on her contralateral side is grossly normal.

Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.

NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.

© The American Medical Society for Sports Medicine
4000 W. 114th Street, Suite 100
Leawood, KS 66211
Phone: 913.327.1415

Website created by the computer geek