Diagnosing Elbow Sprains & Strains

Orthopaedists at NYU Langone’s Center for Musculoskeletal Care are experts in diagnosing elbow sprains and strains. These injuries occur when different parts of the elbow stretch or tear.

The elbow joint makes it possible to bend and straighten the arm and to rotate the forearm so that the palm of the hand faces up or down. The elbow is actually made up of three joints. These are where the bones of the upper arm, called the humerus, and those of the forearm, the ulna and radius, come together. These bones are supported by ligaments, tendons, and muscles. Ligaments are tough cords of tissue that attach bone to bone. Tendons attach muscles to bone, and muscles help the elbow to bend, extend, and rotate.

Though you may hear the words “sprain” and “strain” used interchangeably, they are different types of injuries. A sprain occurs when the fibers in a ligament stretch or tear. A strain is a tear in the fibers of a muscle or a tendon. A lack of flexibility and strength in the ligaments, muscles, and tendons that support the elbow can lead to these injuries.

Tendinitis, which is inflammation in a tendon without a stretch or a tear, may require different types of treatments than sprains or strains.

Many elbow sprains or strains are caused by repetitive use of the joint during sports such as tennis or golf or jobs such as carpentry. Overuse of the elbow can irritate the tendons that attach the muscles of the forearm to bone and cause them to swell, strain, or tear—a condition commonly known as “tennis elbow.” This injury can occur regardless of whether you play tennis.

Some elbow sprains and strains occur suddenly, such as when you break a fall with an outstretched arm. These types of injuries can also be caused by twisting the arm or by a blow to the elbow.

Symptoms can include pain, tenderness, or swelling around the elbow during movement or at rest. It can become difficult to bend or extend the elbow, or you may experience bruising, redness, or warmth around the elbow.

Medical History and Physical Examination

An NYU Langone doctor may ask specific questions about your symptoms, including whether they began gradually or appeared after an injury. He or she may ask about any prior injuries to the area and any activities that require repetitive use of the elbow. This is because certain activities, such as hammering or swimming, can affect specific ligaments, muscles, or tendons in the elbow.

During a physical exam, your doctor evaluates how well you can bend and extend your elbow and rotate your forearm and whether these movements cause any pain. He or she may also examine your wrist, neck, and shoulder to determine if injuries in these areas are causing elbow pain.

A doctor may recommend imaging tests to confirm the diagnosis and to distinguish between a sprain and a strain.

X-rays

X-rays use high-energy beams of light to create pictures of the body. Your doctor may recommend an X-ray to examine the bones of the elbow and rule out another cause of the pain, such as a fracture or a dislocation. This test can also determine if an abnormality in the bones or loose pieces of bone are causing your symptoms.

An X-ray may also reveal an accumulation of fluid around the elbow, which is a sign of a sprain or strain.

Ultrasound

In an ultrasound, high-frequency sound waves produce clear images of soft tissue, such as muscles and ligaments. Doctors at NYU Langone use ultrasound to check the tendons for swelling, which can be a sign of tendinitis. This test can also reveal small tears or stretched ligaments, which helps the doctor determine if an elbow injury is the result of chronic overuse.

Many specialists at NYU Langone’s Center for Musculoskeletal Care have ultrasound machines in their offices. Alternatively, your doctor may refer you to a musculoskeletal radiologist at our imaging services.

MRI Scan

In MRI, a powerful magnetic field and radio waves create images of soft tissues inside the body. MRI can detect injuries to deep soft tissue and bones that might not be visible on an ultrasound or X-ray.

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