3. CHIEF COMPLAINT
PAIN AT LATERAL ASPECT OF ELBOW
DIFFICULTY IN ADLS,LIKE-WASHING
CLOTHS,UTENSILS & MAKING FOOD ETC.
DIFFICULTY IN LIFTING AND CARRYING
WEIGHT IN RIGHT HAND.
PAIN RADIATING DISTALLY AT POSTERIOR
ASPECT OF FOREARM.
4. H/O PAST ILLNESS
MEDICAL HISTORY
PATIENT IS HYPERTENSIVE-TAKING
AMLOKIND SINCE LAST 3 YEARS.
SURGICAL HISTORY
H/O (4 HOLE PLATTING WITH DYNAMIC
SCREW)ORIF IS DONE 2 YEARS BACK IN
CASE OF FRACTURE OF NECK OF FEMUR.
5. H/O PRESENT ILLNESS
DIABETIC TREATMENT IS ONGOING
H/O HYPERTENSION
PAIN AT ELBOW RADIATING DOWNWARD
(DISTALLY)
VAS-7 |--------------*------|.
ONSET OF PAIN –CONTINOUS(MODERATELY)
AGGREVATING FACTOR-TWISSTING MOVEMENT
OF FOREARM & WRIST & GRASPING ACTIVITY.
eq: making food, washing cloths, carrying
weight, etc.
RELIEVING FACTOR-REST
6. OBSERVATION
MILD SWELLING PRESENT AROUND THE
LATERAL ASPECT OF RIGHT ELBOW.
REDNESS PRESENT ON LATERAL ASPECT
OF RIGHT ELBOW.
FOREARM SUPPORTED WITH OTHER HAND
i.e. right forearm supported with left
hand.
7. EXAMINATION
ACTIVE MOVEMENT
Elbow flexion is normal
Elbow extension is painful at end range.
Wrist flexion and ulnar deviation is normal.
Wrist extension and radial deviation mildly painful at end range
but range is complete.
Forearm pronation is slightly painful supination is normal
PASSIVE MOVEMENT-normal at all joint only elbow extension is
painful at end range.
RESISTED MOVEMENT
elbow extension wrist extension & radial deviation,forearm
pronation is painful.
All other movement are normal.
8. END FEEL-normal at all noted joint
except soft end feel on right elbow
extension(due to inflamed joint.)
ROM-normal at all movement except
painful wrist extension at end range of
motion.
TENDERNESS –present at lateral aspect
of elbow just below the lateral
epicondyle of humerus.
TEMPRATURE-slightly raise in temp at
lateral aspect of elbow
12. TREATMENT
MODALITIES
COLDPACK-FOR 10 MINS TWICE DAILY.
U.S.-AT 0.7 WATTS PER CM SQUARE AT 50 DUTY CYCLE FOR 6
MINS FOR 10 DAYS(at tender point)
TENS - 4 POLE WITH SMALL ELECTRODES( apply one at above
lateral epicondyle, one below and one on dorsal aspect of
forearm and one on dorsum aspect of hand , covering all
radiated area of pain) for 15 days
TENNIS ELBOW BEND IS PRESCRIBED AND PRECUATION ARE
EXPLAINED.
REST THE ELBOW FOREARM AND WRIST FOR 10 DAYS.
13. PROGNOSIS
15% RELIEVE ON 3RD VISIT.
25% RELIEVE ON 5TH DAY
35% RELIEVE ON 8TH VISIT (FREE MOVEMENTS ARE STARTED)
55% RELIEVE ON 10TH DAY, U.S. IS DISCONTINUE AND VAS IS
DROP DOWN TO 4 ,improvement in ADLs activities.
Isometrics are started-10 sec.hold-10 rpm-BD
80% RELIEVE ON 15TH DAY ,TENS IS DISCONTINUE.
Allow to do ADLs
Resisted exercises with ½ kg weight is started.
Follow PRE program.
