Elbow

The elbow has a very complex anatomy and function. It is formed where the humerus, radius and ulna meet. The elbow is exposed to injuries as well as to a range of other diseases and conditions. The most common are overuse syndromes – so-called tennis elbow (lateral epicondylitis) and golfer's elbow (medial epicondylitis) – which arise mainly from intensive sporting activity, in manual workers and from computer work; interestingly, surgeons and dentists also often have them. Metabolic diseases such as diabetes and gout can affect the elbow and the surrounding structures, causing bursitis and arthritis. Autoimmune inflammatory diseases such as rheumatoid arthritis (RA) and psoriatic arthritis, in addition to other joints in the body, can also affect the elbow, reducing its movement and destroying joint structures; in RA, rheumatoid nodules also develop.

The consequences of injury vary – from reduced movement, dislocation and subluxation to fractures (of the olecranon or the head of the radius). Myositis ossificans, heterotopic ossification and osteochondritis dissecans develop as a result of injury, but also idiopathically (without a known cause).

Elbow rehabilitation requires a relatively shorter period of immobilisation than other joints, because the elbow is very prone to contractures. Careful analysis of diagnostic images (X-ray, ultrasound) is important. Normal elbow movements should be pain-free, through the full range of motion and able to bear load. Extension and flexion cover a range of 0/140 degrees, and supination and pronation 90/80 degrees. A normal elbow angles away from the body so that it can carry loads, although this varies from person to person. Besides ligaments and tendons, a number of blood vessels and nerves pass through and around the elbow, and of these the ulnar nerve is the most exposed to injury in this area.