09 May 2014

Let's shake on it

A construction worker came into our primary care clinic complaining of left elbow pain that was worse with activity. Based on his description, the location of his pain, and my exam, I thought it was lateral epicondylitis ("tennis elbow"). I couldn't remember the best physical exam maneuvers for lateral epicondylitis, so I excused myself from the room and opened up my physical examination textbook. The book described a simple maneuver called the "Handshake Test."

I went back in and shook the patient's right hand. Then I asked to shake his left hand. The next moment, he was doubled over in pain.

Diagnosis made. Sometimes it can be that simple.