The causes of elbow arthritis are numerous, from osteoarthritis to post-traumatic arthritis to secondary to generalised inflammatory arthritis. Patterns of elbow arthritis are incompletely understood, and work is currently underway to see if the arthritis is secondary to an instability, or whether there are specific patterns of instability that develop secondary to specific pathology. As the causes are many, equally there are numerous different presentations from elbow pain, to locking, to stiffness, and each patient will present their experience differently.
The elbow consists of the ulno-humeral joint, the radio-capitellar joint and the proximal radio-ulnar joint. Each of these might be affected, but mostly it is a combination of varying involvement of all three. Some stiffness is quite well tolerated in flexion and extension, as the very mobile shoulder joint and the dexterous wrist and hand below can compensate well. The so-called ‘functional’ range of the elbow joint is 30°-130° (extension-flexion).
In early stages patients complain of exacerbations of pain, usually with some elbow swelling, stiffness and a history of catching, clicking or locking if there are some offending osteophytes or loose bodies inside the joint.