Clinical reasoning

To help the student understand how the assessments work, these diagnostic guides outline the path that the assessments take that lead to relevant treatment...

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elbow

Osteoarthritis

diagnosis step

1: Has there been a fall/ trauma? No = go 2


diagnosis step

2: Has there been an onset of pain following lifting or twisting the arm? No = go 4


diagnosis step

4: Is the patient over 60 and affected by increased global joint swelling? Yes = Osteoarthritis

Osteoarthritis treatment
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elbow

Nerve compression

test

1: Has there been a fall/ trauma? No = go 2


test

2: Has there been an onset of pain following lifting or twisting the arm? Yes = go 3


test

3: Is there a deformity anywhere? No = go 5


test

5: Feel the outside of the elbow, is it painful? No = go 6


test

6: Feel the inside of the elbow, is it painful? No = go 7


test

7: Is increased muscle tension evident? No = go 8


test

8: Are there any pins and needles or numbness? Yes = go 9


test

9: Lightly touch both arms, does it feel the same both sides? No = Nerve compression

Nerve compression treatment
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elbow

Myofascial tightness

test

1: Has there been a fall/ trauma? No = go 2


test

2: Has there been an onset of pain following lifting or twisting the arm? No = go 4


test

4: Is the patient over 60 and affected by increased global joint swelling? No = go 5


treatment

5: Feel the outside of the elbow, is it painful? No = go 6


test

6: Feel the inside of the elbow, is it painful? No = go 7


test

7: Is increased muscle tension evident? Yes = go 10


test

10: Pick up skin and roll it between fingers…does it feel painful and tight? Yes = Myofascial tightness

Myofascial tightness treatment
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elbow

Golfers elbow

test

1: Has there been a fall/ trauma? No = go 2


test

2: Has there been an onset of pain following lifting or twisting the arm? Yes = go 3


test

3: Is there a deformity anywhere? No = go 5


test

5: Feel the outside of the elbow, is it painful? No = go 6


test

6: Feel the inside of the elbow, is it painful? Yes = go 11


test

11: Resist flexion of the wrist, is it painful? Yes = Golfers elbow

Golfers elbow treatment
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elbow

Biceps Rupture

test

1: Has there been a fall/ trauma? Yes = go 3


test

3: Is there a deformity anywhere? Yes = go 12


test

12: Is there a bulge in the middle of the bicep region? Yes = Biceps Rupture

Biceps Rupture treatment
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elbow

Tennis Elbow

test

1: Has there been a fall/ trauma? No = go 2


test

2: Has there been an onset of pain following lifting or twisting the arm? Yes = go 3


test

3: Is there a deformity anywhere? No = go 5


test

5: Feel the outside of the elbow, is it painful? Yes = go 13


test

13: Resist extension of the wrist, is it painful? Yes = Tennis Elbow

Tennis Elbow treatment
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elbow

Elbow fracture

test

1: Has there been a fall/ trauma? Yes = go 3


test

3: Is there a deformity anywhere? Yes = go 12


test

12: Is there a bulge in the middle of the bicep region? No = go 14


test

14: Is there any obvious bony deformity and bruising? Yes = Elbow fracture

Elbow fracture treatment
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elbow

Olecranon Bursitis

test

1: Has there been a fall/ trauma? No = go 2


test

2: Has there been an onset of pain following lifting or twisting the arm? No = go 3


test

3: Is there a deformity anywhere? Yes = go 12


test

12: Is there a bulge in the middle of the bicep region? No = go 14


test

14: Is there any obvious bony deformity and bruising? No = go 15


test

15: Is there an obvious swelling on the bony back of the elbow? Yes = Olecranon Bursitis

Olecranon Bursitis treatment
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