Valgus stress test (Albue)
- Fysiobasen
- Oct 3
- 2 min read
The Elbow Valgus Stress Test is a clinical examination used to assess the integrity of the medial collateral ligament (MCL), also known as the ulnar collateral ligament (UCL). This ligament provides critical stability against valgus stress at the elbow joint. Injuries are common in athletes involved in repetitive overhead throwing motions, such as baseball pitchers, javelin throwers, and handball players.
Procedure
Patient position
The patient can be positioned supine, seated, or standing.
Relaxation is important to avoid muscular guarding.
Execution
The examiner flexes the elbow to approximately 20°.
One hand palpates the medial joint line, while the other hand stabilizes the distal humerus.
A valgus stress is applied by pulling the forearm laterally while keeping the humerus fixed¹².
Interpretation
Positive test: Pain along the medial elbow or increased laxity compared to the contralateral side → suggests possible MCL injury³.
Negative test: No pain or excessive motion observed.
The test may be repeated at different degrees of elbow flexion/extension to assess various portions of the MCL⁴.
Diagnostic accuracy
Evidence supporting the Elbow Valgus Stress Test is limited.
The Moving Valgus Stress Test demonstrates better diagnostic validity and is often considered more reliable for identifying MCL pathology⁵.
Clinical relevance
Useful as a quick screening tool for medial elbow instability.
Should not be used in isolation due to limited sensitivity and specificity.
Best applied in combination with:
Moving Valgus Stress Test
Milking Maneuver
Imaging (MRI/ultrasound) for confirmation.
Summary
The Elbow Valgus Stress Test is a simple and clinically useful maneuver for detecting medial elbow instability. While it can suggest MCL injury, its diagnostic accuracy is limited, and it should be combined with other tests and imaging for more precise evaluation.
References
Flynn, T.W., Cleland, J.A., Whitman, J.M. (2008). User's guide to the musculoskeletal examination: Fundamentals for the evidence-based clinician. Buckner, Kentucky: Evidence in Motion
Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.
Flynn, T.W., Cleland, J.A., Whitman, J.M. (2008). User's guide to the musculoskeletal examination: Fundamentals for the evidence-based clinician. Buckner, Kentucky: Evidence in Motion
Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.
CR Technologies. Valgus Stress Test - Elbow (CR). Available from: http://www.youtube.com/watch?v=Cd25qGCo-kQ [last accessed 26/03/14]
