The Elbow

Arthrosis

This is a common condition in the late middle-age and is often bilateral
The disorder may come on spontaneously or as the result of a fracture,
repeated minor injury or a loose body in the joint.

Usually there is only minor discomfort. The patient may complain that,
after excessive use, the elbow aches slightly.

The most common inconvenience is the inability to straighten the arm fully.

On clinical examination a slight to moderate capsular pattern is found.
The end-feel at extension is hard ligamentous (not the normal bone to bone) and
the end-feel on flexion is hard ( not the normal soft tissue approximation).
A coarse crepitus is usually present.
Resisted movements are negative.

The radiograph shows joint space narrowing, subchondral sclerosis and hypertrophic
bone changes. Loose bodies may be seen (usually in the olecranon fossa.
However, a positive radiograph can be compatible with full range and painless function !!

Traumatic arthritis
An arthrotic elbow usually does not of itself cause much symptoms but may give rise to
the development of a traumatic arthritis.
Pain in an "arthrotic" elbow is usually caused by a traumatic arthritis that has developed
on top of the arthrosis.

Treatment:

An uncomplicated artrosis does not need treatment.
A traumatic arthritis on top of an underlying arthrosis is treated in the usual way.