Maudsley Test

Maudsley Test (or tennis elbow test) is used for lateral epicondylitis of the elbow joint, also known as ”Tennis Elbow”.

How do you perform Maudsley’s test?

• The patient is seated facing the clinician.
• Using one hand, the examiner resists extension of the 3rd digit of the hand, stressing the extensor digitorum muscle and tendon, while palpating the patient’s lateral epicondyle with the other hand.

What does a positive Maudsley Test mean?

A positive maudsley test is indicated by pain over the lateral epicondyle of the humerus.

See Also: Cozen's Test

Maudsley’s Test Accuracy

A study by Saroja ¹ was done to analyze the diagnostic accuracy of the provocative tests in the diagnosis of lateral epicondylitis of the elbow (Cozen’s test, Mills test and Maudsley test), he found the maudsley’s test to have the following accuracy:

• Sensitivity: 88 %
• Specificity: 0 %

This study, concludes that Mills test has an excellent diagnostic value for ruling in tennis elbow.

See Also: Mills test

Other Tennis Elbow Special Test:

There is other Tennis Elbow Special Tests that are less commonly used to diagnosis the lateral epicondylitis of the Elbow , these includes:

1. Chair Test:

The patient is requested to lift a chair. The arm should be extended with the forearm pronated.

Occurrence of or increase in pain over the lateral epicondyle and in the extensor tendon origins in the forearm indicates lateral epicondylitis.

2. Bowden Test:

The patient is requested to squeeze a blood-pressure cuff that has been inflated to about 30 mm Hg (about 4.0 kPa) with his or her hand; alternatively, ask the patient to maintain a pressure specified by the examiner by squeezing the cuff.

Occurrence of or increase in pain over the lateral epicondyle and in the extensor tendon origins in the forearm indicates epicondylitis.

LATERAL EPICONDYLOSIS (TENNIS ELBOW)

Lateral epicondylitis (tennis elbow ) is one of the most common causes for symptoms related to the elbow. The pain is arising from the origin of extensor carpi radialis brevis (ECRB) at the lateral epicondyle.

Tennis elbow may be caused not only by playing tennis but also by numerous other stressors that cause repeated activation of the wrist extensors.

Sudden traumatic onset is suggestive of an acute tendon rupture that often requires surgical repair.

Treatment:

NON-OPERATIVE TREATMENT:

• Activity modification and physiotherapy will speed up recovery. This means identification and avoidance of precipitating factors, and an eccentric loading regime for the common wrist extensors.
• A static wrist splint may help with pain control.
• Steroid injection will provide short-term pain relief but recurrence rates are high and the elbow is more likely to be painful in the long term.
• Autologous blood product injection may have a role.

OPERATIVE TREATMENT:

• If the pain persists despite adequate non-surgical measures, tendon debridement can provide pain relief in approximately 85% of cases.
• Surgery can be performed as an open procedure with an average of 6 weeks recovery, or using arthroscopic technique with a faster recovery of 2 weeks but a higher risk of nerve injury.

Reference

1. Saroja, G & Leo, Antony & venkata sai, Pm. (2014). DIAGNOSTIC ACCURACY OF PROVOCATIVE TESTS IN LATERAL EPICONDYLITIS. International Journal of Physiotherapy and Research. 2. 815-823. 10.16965/ijpr.2014.699. LINK
2. Clinical Tests for the Musculoskeletal System 3rd Edition.
3. Dutton’s Orthopaedic Examination, Evaluation, And Intervention 3rd Edition.