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Updated: Jul 17, 2026
07:56
A Standardized Method for Measurement of Elbow Kinesthesia
Published on: October 10, 2020
Can a normal range of elbow movement predict a normal elbow x ray?
Robert I Lennon1, Manjeet S Riyat, Rachel Hilliam
1Derby Hospitals, NHS Foundation Trust, London Road, Derby DE1 2QY, UK. iain.lennon@nhs.net
Emergency Medicine Journal : EMJ
|January 26, 2007
Summary
Elbow injuries are common in emergency departments. A normal range of motion and full extension can help identify patients who do not need elbow x-rays, reducing unnecessary radiation exposure.
Area of Science:
- Orthopedic Surgery
- Emergency Medicine
- Radiology
Background:
- Elbow injuries constitute 2-3% of emergency department visits.
- High rates of radiography and missed fractures are associated with elbow injuries.
- This study investigates clinical examination components correlating with normal elbow radiographs.
Purpose of the Study:
- To identify clinical examination findings that best predict normal elbow radiographs.
- To develop a clinical rule for managing elbow injuries and reduce unnecessary imaging.
Main Methods:
- Prospective study in a district general hospital's emergency department.
- Inclusion of patients with elbow injuries, excluding those unable to cooperate.
- Data collection via proforma on clinical examination features and radiograph results.
Main Results:
- Full elbow extension showed high specificity (0.916) for normal radiographs.
- Equal range of motion (ROM) demonstrated high specificity (0.976), especially in patients under 16 (specificity 1.000).
- Logistic regression identified a combination of full extension, flexion, and supination as best predictors.
Conclusions:
- A two-tier clinical rule is proposed for elbow injury management.
- Patients under 16 with equal ROM may be safely discharged without radiographs.
- Normal extension, flexion, and supination indicate no need for emergent elbow radiographs.
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