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Differential Diagnosis of Lateral Elbow Pain

presented by Ann Porretto-Loehrke

Accreditation Check:

Why is treating a “simple” tennis elbow diagnosis sometimes so difficult? This course will help guide you through a systematic approach to evaluating a patient with lateral elbow pain to identify the pain-generator. Determining the patient’s impairments will provide guidance for addressing treatment, which will be covered in the subsequent course. Recognizing when special tests are needed and performing a systematic clinical examination will be presented.

CHTs, when submitting this for recertification through HTCC, this course can be used for CAT B (hand therapy courses < 3 hours in length); however, if this course certificate is submitted with the following course certificates listed below (or any combination totaling 3 hours or more), they can be submitted under CAT A (hand therapy courses > 3 hours in length).

  • Differential Diagnosis of Lateral Elbow Pain (2 hours)
  • Treatment of Lateral Elbow Pain (1.5 hours)


  • Meet Your Instructor

    • Ann Porretto-Loehrke, PT, DPT, CHT, COMT, CMTPT

      Ann Porretto-Loehrke is a skilled clinician and dynamic instructor. She is the therapy manager of a large department at the Hand to Shoulder Center. Ann is a Certified Hand Therapist (CHT) and a Certified Orthopedic Manual Therapist (COMT) for treatment of the upper quadrant through the International Academy of Orthopedic Medicine (IAOM). She has extensive training in the evaluation and treatment of the upper quadrant. Ann completed a post-professional Doctorate in Physical Therapy (DPT) degree from Drexel University with a specialty in hand and upper quarter rehabilitation. Most recently, Ann has become certified in dry needling through Myopain Seminars, as a Certified Myofascial Trigger Point Therapist (CMTPT). She previously served as the Vice-Chair of the Examination committee for the Hand Therapy Certification Commission (HTCC). Ann also previously served as the Northeast District chair for the Wisconsin Physical Therapy Association from 2004 to 2008. She is a lead instructor who developed the Hand & Upper Extremity Track through IAOM, a set of six manual therapy courses designed specifically for hand and upper extremity specialists. Ann has presented at American Society of Hand Therapists (ASHT) annual conferences, Canadian Hand Conferences, Philadelphia meeting, and Teton Hand Conference.

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    Chapters & Learning Objectives

    Download Learning Objectives
    1. Anatomy of the Lateral Elbow

      1. Anatomy of the Lateral Elbow

      This chapter provides an overview of the anatomy in the lateral elbow including the humeroradial joint, lateral ligamentous support, musculotendinous structures, and radial nerve. Having a solid understanding of these structures and their location will give better insight of the involved structure when performing the clinical examination.

    2. Pathomechanics of Lateral Elbow Pain

      2. Pathomechanics of Lateral Elbow Pain

      This chapter covers the pathomechanics of tendinopathy, articular, ligamentous, and neural issues at the lateral elbow.

    3. Clinical Examination

      3. Clinical Examination

      This chapter provides a systematic approach to differentiating between musculotendinous, articular, ligamentous, and neural issues at the lateral elbow. An analysis of recognizing special tests needed and performing these will be showcased.