Varus stress test (Elbow)
- Fysiobasen
- Oct 3
- 2 min read
The Elbow Varus Stress Test is a clinical maneuver used to assess the integrity of the lateral collateral ligament (LCL) of the elbow. The LCL plays a crucial role in resisting varus forces and maintaining lateral stability of the joint. Injury to the LCL may lead to lateral elbow instability, often associated with trauma, repetitive overload, or ligamentous insufficiency.
Test Procedure
Patient Position
The test is typically performed with the patient in a standing position, although it can also be performed seated or supine for greater examiner control.
The elbow is placed in slight flexion to unlock the joint capsule.
Examiner’s Position and Execution
The examiner palpates the humeroulnar joint line.
One hand stabilizes the distal humerus.
The other hand applies a varus force by drawing the forearm medially relative to the humerus【1】.
The test is most commonly performed with the elbow flexed between 5° and 30°, where the ligament is most isolated【2】.
Interpretation
Positive test: Reproduction of pain at the lateral elbow or noticeable increased laxity compared to the contralateral side, suggesting LCL injury.
Negative test: No pain or abnormal joint movement observed.
Clinical Relevance
The Elbow Varus Stress Test is particularly useful for:
Identifying LCL injuries following elbow dislocation or trauma.
Assessing chronic lateral elbow instability caused by repetitive valgus/varus loading.
Differentiating ligamentous pathology from other lateral elbow conditions, such as lateral epicondylitis (tennis elbow).
Because subtle instability can be difficult to detect, this test should be interpreted in combination with other assessments, including:
Valgus stress test for comparison.
Moving valgus stress test for medial pathology.
Imaging such as MRI or stress radiographs for definitive evaluation.
Conclusion
The Elbow Varus Stress Test is a simple but effective method to assess the stability of the lateral collateral ligament. While it is a valuable tool in the clinical setting, its diagnostic accuracy increases when combined with other elbow stability tests and imaging modalities.
Sources:
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. Varus Stress Test - Elbow (CR). Available from: http://www.youtube.com/watch?v=rcIGQ7daGek [last accessed 26/03/14]
