Narrative review linking elbow osseous and ligamentous anatomy to the biomechanics of three classic instability patterns—valgus instability, posterolateral rotatory instability (PLRI), and varus posteromedial rotatory instability (VPMI)—then systematically mapping each pattern to its diagnostic examination maneuvers and optimal imaging modality.
When evaluating a throwing athlete with medial elbow pain, use the moving valgus stress test (not the standard valgus stress test) — it exploits the 70°–120° instability window and is far more sensitive.
For a patient with lateral elbow pain and apprehension on push-up maneuvers, combine the chair push-up and prone push-up tests to maximize PLRI detection in the clinic, reserving the lateral pivot-shift test for the OR.
Narrative review linking elbow osseous and ligamentous anatomy to the biomechanics of three classic instability patterns—valgus instability, posterolateral rotatory instability (PLRI), and varus posteromedial rotatory instability (VPMI)—then systematically mapping each pattern to its diagnostic examination maneuvers and optimal imaging modality.
When evaluating a throwing athlete with medial elbow pain, use the moving valgus stress test (not the standard valgus stress test) — it exploits the 70°–120° instability window and is far more sensitive.
For a patient with lateral elbow pain and apprehension on push-up maneuvers, combine the chair push-up and prone push-up tests to maximize PLRI detection in the clinic, reserving the lateral pivot-shift test for the OR.