Elbow
Ligamentous Instability (Medial)
Evidence: confirmed
Elbow Valgus Stress Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Assessing the integrity of the Medial Ulnar Collateral Ligament (UCL).
- Primary test for medial elbow instability.
How to Perform
- Position: Flex the patient's elbow to 20-30° to unlock the olecranon bone from its fossa.
- Action: Stabilize the patient's wrist with one hand and support the elbow with the other.
- Force: Apply a valgus (inward) force to the elbow while externally rotating the arm.
Interpretation of Results
- Positive Test: Pain on the medial aspect of the elbow or excessive gapping (laxity) compared to the uninjured side.
Diagnostic Accuracy
- Sensitivity: 50-65% (Higher in acute injuries)
Clinical Context & Limitations
The Elbow Valgus Stress Test should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Elbow region, combining the Elbow Valgus Stress Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
- Orthobullets.com
