A patient presents with posterior elbow pain and a locking sensation during a valgus stress with dynamic extension. Which test would best confirm this diagnosis?

A patient presents with posterior elbow pain and a locking sensation during a valgus stress with dynamic extension. Which test would best confirm this diagnosis?

• A. Hornblower sign
• B. Maximum elbow flexion test / compression test
• C. Reverse Mills test
• D. Valgus overload test of the elbow

Answer: (D)

Posterior elbow impingement from valgus extension overload is being assessed. In throwers and athletes with repetitive throwing, applying valgus stress while moving the elbow through extension loads the posterior compartment of the elbow, including the olecranon and capitellum. This can reproduce pain and, if a loose body or osteochondral lesion is present, a locking sensation as the posterior structures impinge or catch during motion. The valgus overload test precisely provocative the posteromedial/posterior elbow, so a positive result strongly points to posterior impingement or related intra-articular pathology. Other tests on the list target different issues—tendinopathy, instability, or other aspects of elbow function—without specifically loading the posterior joint under valgus extension to provoke impingement, which is why this maneuver is the best choice here.

Posterior elbow impingement from valgus extension overload is being assessed. In throwers and athletes with repetitive throwing, applying valgus stress while moving the elbow through extension loads the posterior compartment of the elbow, including the olecranon and capitellum. This can reproduce pain and, if a loose body or osteochondral lesion is present, a locking sensation as the posterior structures impinge or catch during motion. The valgus overload test precisely provocative the posteromedial/posterior elbow, so a positive result strongly points to posterior impingement or related intra-articular pathology. Other tests on the list target different issues—tendinopathy, instability, or other aspects of elbow function—without specifically loading the posterior joint under valgus extension to provoke impingement, which is why this maneuver is the best choice here.