Author: Ramsey Al-Khalil, BA
Co Author #1: Kamalpreet Buttar
Editor: Caitlyn Mooney, MD
Senior Editor: Margaret Gibson, MD
44-year-old male, right hand dominant, presents with right-sided elbow pain. Flu-like symptoms and a syncopal episode four months prior for which patient underwent repair of chin laceration. CT head, ECG, and transthoracic echocardiogram done with no abnormalities; continuing elbow pain. Flu symptoms resolved spontaneously over weeks, but elbow and forearm pain persisted. Tried NSAIDs and PT for the elbow pain with residual "soreness" rather than sharp shooting pain. Weakness is present consistently but worse with activity or lifting. Ache is located at mid-elbow and radiates down forearm proximal to thumb.
Past medical, procedural, family, and social histories unremarkable. No medications or allergies. ROS negative except for HPI.
MSK: No deformity of the right elbow. Full ROM of the elbow and wrist flexion/extension. Full ROM of forearm supination/pronation. Mild weakness on resisted pronation of maximally flexed elbow. No pain with resisted wrist extension/flexion. Nontender lateral or medial condyles. Negative "O.K". and "pinch" tests.
Extremities: Sensation intact in upper extremities. Well perfused and no edema.
Skin: No rashes.
Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.