Differential Diagnosis of Lateral Elbow Pain – Live 2019 Update

Presented by Ann Porretto-Loehrke, PT, DPT, CHT, COMT, CMTPT

Meet Your Instructor

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

Learning Objectives

  • Articulate key anatomic structures that could be involved with lateral elbow pain: humeroradial joint, extensor carpi radialis brevis (ECRB), extensor digitorum communis (EDC), lateral ulnar collateral ligament, and radial nerve
  • Demonstrate how to locate the following bony structures: lateral supracondylar ridge, lateral epicondyle, capitulum, radial head
  • State the muscle most commonly involved with lateral tendinopathy
  • Describe how radial head hypermobility and hypomobility can contribute to lateral elbow pain
  • Explain the pathomechanics of posterolateral rotatory instability (PLRI)
  • Describe the five areas of potential nerve entrapment for the radial nerve at the lateral elbow
  • Perform resisted tests to determine the difference between an ECRB tendinopathy, EDC tendinopathy and HRJ issue
  • Discuss special tests to determine radial head hypermobility versus HRJ hypomobility
  • Determine when special tests are needed to rule out posterolateral rotatory instability
  • Explain how a positive valgus stress test can contribute to lateral elbow pain
  • Perform the upper limb neurodynamic test #2 to evaluate tension on the radial nerve


5:00pm-5:25pm Chapter 1: Anatomy of the Lateral Elbow
5:25pm-5:45pm Chapter 2: Pathomechanics of Lateral Elbow Pain
5:45pm-6:15pm Chapter 3: Clinical Examination
6:15pm-6:25pm Break
6:25pm-6:30pm Poll Review
6:30pm-7:00pm Chapter 4: 2019 Update
7:00pm-7:30pm Question & Answer Session