Physical examination of the elbow, what is the evidence? A systematic literature review

Authors Elisa L. Zwerus, Matthijs P. Somford, François Maissan, Jelle Heisen, Denise Eygendaal, Michel P.J. van den Bekerom
Published in British Journal of Sports Medicine
Publication date 2018
Research groups Lifestyle and Health
Type Article


Objective Primary to provide an overview of diagnostic accuracy for clinical tests for common elbow (sport) injuries, secondary accompanied by reproducible instructions to perform these tests. Design A systematic literature review according to the PRISMA statement. Data sources A comprehensive literature search was performed in MEDLINE via PubMed and EMBASE. Eligibility criteria We included studies reporting diagnostic accuracy and a description on the performance for elbow tests, targeting the following conditions: distal biceps rupture, triceps rupture, posteromedial impingement, medial collateral ligament (MCL) insufficiency, posterolateral rotatory instability (PLRI), lateral epicondylitis and medial epicondylitis. After identifying the articles, the methodological quality was assessed using the QUADAS-2 checklist. Results Our primary literature search yielded 1144 hits. After assessment 10 articles were included: six for distal biceps rupture, one for MCL insufficiency, two for PLRI and one for lateral epicondylitis. No articles were selected for triceps rupture, posteromedial impingement and medial epicondylitis. Quality assessment showed high or unclear risk of bias in nine studies. We described 24 test procedures of which 14 tests contained data on diagnostic accuracy. Conclusions Numerous clinical tests for the elbow were described in literature, seldom accompanied with data on diagnostic accuracy. None of the described tests can provide adequate certainty to rule in or rule out a disease based on sufficient diagnostic accuracy.

On this publication contributed

Language English
Published in British Journal of Sports Medicine
Year and volume 52 19
Key words onderzoek, fysiotherapie, elleboog
Page range 1253-1260

Francois Maissan

Francois Maissan | Researcher | Research group Lifestyle and Health

Francois Maissan

  • Researcher
  • Research group: Lifestyle and Health