Can elbow-extension test be used as an alternative to radiographs in primary care?

Andreas Lamprakis, Kostas Vlasis, Ekaterini Siampou, Ilias Grammatikopoulos, Christos Lionis

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To evaluate the ability of elbow extension, with the patient in a supine position, as a diagnostic test of an insignificant injury, with the purpose of avoiding unnecessary radiographs. Methods: Seventy patients suffering from an acute elbow injury were examined at the accident and emergency department. Inability to fully actively extend the elbow in a supine position was defined as a positive diagnostic test. Radiographs were interpreted by a consultant radiologist, blinded to all clinical examination results. Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios along with their 95% confidence intervals were calculated for the elbow-extension test. Results: Forty out of 70 patients had a positive test. Elbow fracture or dislocation was identified radiographically in 22 patients with positive test (sensitivity 92%). Two out of 30 (with negative test) had a hairline radial head fracture, which was found on radiographs (specificity 61%). Conclusion: Elbow extension as a diagnostic test in a primary care setting can predict severe elbow injuries and can be safely used in practices with no radiology facilities.

Original languageEnglish
Pages (from-to)221-224
Number of pages4
JournalEuropean Journal of General Practice
Volume13
Issue number4
DOIs
Publication statusPublished - Dec 2007

Keywords

  • Elbow extension
  • Elbow injury
  • Elbow-extension test
  • General practice
  • Radiographs

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