Elbow Goniometry

Flexion

Patient Instructions:

Ask the patient to bend their elbow as far as they can, try and touch their shoulder.

Starting Position:

·        Supine, arm should be in the anatomical position.  It will be easier to align the goniometer if the arm of the patient is resting on the edge of the table.

·        The fulcrum should be aligned with the lateral epicondyle of the humerus.

·        The stationary arm is positioned along the midline of the humerus, the moving arm is aligned with the radial styloid process.

Ending Position:

·        The arm is now flexed at the elbow, the goniometer should still be aligned with the correct anatomical landmarks as described below. 

Normal ROM is between 150-160 degrees, the patient has 155 degrees of elbow flexion.

Pronation

Patient Instructions:

            Have the patient turn their wrist down toward the ground.

Starting Position:

·        Patient sitting up with elbow bent 90 degrees and at patient’s side, wrist in a handshake position.

·        The fulcrum is placed just behind the ulnar styloid process.

·        The moving arm and stationary arm are parallel with the anterior midline of the humerus.

Ending Position:

·        The fulcrum should remain in the same position as above.

·        The stationary arm will still be aligned parallel to the midline of the humerus, the moving arm will lie across the dorsum of the forearm just behind the ulnar and radial styloid processes.

Normal ROM is 90-96 degrees, the patient has 95 degrees of pronation.

Supination

Patient Instructions:

Have the patient turn their palm up as if they are holding something in the palm of their hand.

Starting Position:

·        Patient position is the same as for pronation.

·        The goniometer is placed on the medial aspect of the forearm with the fulcrum at the radioulnar joint.

·        The arms are both aligned with the anterior midline of the humerus.

Ending Position:

·        The moving arm will be resting on the medial forearm at the radioulnar joint.  The moving arm should remain parallel to the midline of the humerus. 

Normal ROM is 81-93 degrees, the patient has 90 degrees of supination.

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