There is no line of demarcation between the shoulder and elbow regions. Pain in the arm may originate at the shoulder with reference downwards or less often at the elbow with reference upwards. Most pains indicated by the patient at the elbow or forearm have a local origin, since at the more distal part of the upper limb the capacity for correct lo-calizaiotn is good.
Once it is clear that the elbow region is at fault, the joint and the muscles about it are tested by ten movements.
1. Four. Passive extension, flexion, pronaiton, supination-ful range, LOM, painful, pain-less.
2. Four. Resisted extension, flexion, pronaion, supination-strong, weak, painful, painless.
3. Two. Resisted flexion, extension at the wrist-painful, painless.
The muscles that perform theses two movements arise from the humeral epicondyles and a lesion in either often causes pain felt at the elbow although the tissuse affect-ed is not functionally a part of the elbow(i.e. Tennis elbow and Golfer´s elbow).
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