Clinical evaluation of the elbow in throwers

The elbow is a vital part of the complicated and intricate mechanism known as throwing. The athlete that participates in a throwing sport walks a fine line between success and injury. It is this line that the clinician must monitor. When an athlete admits that an injury has occurred, it is up to the physician to listen, observe, and examine the player in great detail. Injuries that involve the elbow are complex and difficult to evaluate; therefore, it is essential that a thorough, complete, and reproducible evaluation be performed every time. Not only is this important initially, but is invaluable when following up on the athlete over the course of the injury. The patient's history is the initial tool used to narrow the differential diagnoses. Questioning is concise, structured, and not leading. The result is a workable list of possible diagnosis that will aid the examiner when the physical examination is performed. The physical, like the history, is well outlined and defined. This methodology allows the clinician to be structured when evaluating the results. In the end, a complete history and physical examination may not be enough to draw a final conclusion to the etiology of the athlete's elbow injury. Ancillary studies should then be evaluated for their value and effectiveness in aiding the examiner to achieve a correct diagnosis. The purpose of this report is to provide the clinician a template that will give consistent results and aid in the diagnosis of elbow injuries.