IMAGING
GONIOMETRY
Fundamentals of Musculoskeletal Imaging, 5th Edition Lynn N. McKinnis, PT, DPT, OCS A volume in the Contemporary Perspectives in Rehabilitation Series. Curated by Steven L. Wolf, PT, PhD, FAPTA, FAHA, FASNR
Norkin & White’s Measurement of Joint Motion A Guide to Goniometry, 6th Edition D. Joyce White, PT, DSc, MS
NEW EDITION!
Resources on FADavis.com
Resources on FADavis.com
Can your students accurately interpret imaging? Develop the skills and knowledge students need to accurately interpret imaging studies and understand written reports as an integral component of a comprehensive patient evaluation, more specific treatment plans, and better outcomes. ACR Guidelines Routine radiologic evaluations for each anatomic region and joint that explain how the image is recorded and how the patient is positioned Real-life case studies that demonstrate how to integrate imaging into interventions and clinical practice “Interactive Imaging Practice” application and MRI tutorial 736 pages │ 1,340 illustrations │ Hard cover │ 2021 $154.95 (US) ISBN-13: 978-0-8036-7602-2
Complete coverage of goniometry measurements & muscle length tests—now with all-new, full-color photographs Can your students measure movement impairments and continually assess rehabilitation status? A consistent, easy-to-follow format and exceptional photographs help them visualize what they are reading. § NEW! Over 360 all-new, full-color photographs show how to perform joint measurement techniques and identify the underlying anatomy. § NEW & EXPANDED! Tables summarize current research findings on the reliability of assessing joint motion and muscle length with universal goniometers and, where appropriate, inclinometers, tape measures, and smartphone applications. § UPDATED & REVISED! Methods of measuring wrist and hand motions incorporate the methods recommended by the American Society of Hand Therapists § UPDATED! Evidence addresses age, gender, and body mass, as well as the effects of the testing process such as testing position and type of measuring instrument on range of motion and muscle length. 623 pages | 403 Illustrations | Soft cover, spiral-bound | Late 2025 $87.95 (US) ISBN 13: 978-1-7196-4241-5 CHAPTER 5 The Elbow and Forearm 135
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Upper-Extremity Testing
PART II
ELBOW FLEXION Motion occurs in the sagittal plane around a medial– lateral axis. Normal flexion ROM values for adults range from about 140 to 150 degrees. See Research Findings and Tables 5.1 to 5.4 for normal ROM values by age and gender. Testing Position Position the individual supine with the shoulder in 0 degrees of flexion, extension, and abduction so that the arm is close to the side of the body. Place a pad or towel roll under the distal end of the humerus to allow full elbow extension. Position the forearm in full supination with the palm of the hand facing the ceiling. Stabilization Stabilize the humerus to prevent flexion of the shoulder. The pad under the distal humerus and the examining table prevents extension of the shoulder. Testing Motion Flex the elbow by moving the hand toward the shoulder. Maintain the forearm in supination during the motion (Fig. 5.13). The end of flexion ROM occurs when resistance to further motion is felt and attempts
to overcome the resistance cause motion of the shoulder. Normal End-Feel Usually, the end-feel is soft because of compression of the muscle bulk of the anterior forearm with that of the anterior upper arm. If the muscle bulk is small, the end-feel may be hard because of contact between the coronoid process of the ulna and the coronoid fossa of the humerus and because of contact between the head of the radius and the radial fossa of the humerus. The end-feel may be firm because of tension in the posterior joint capsule, the lateral and medial heads of the triceps muscle, and the anconeus muscle. Goniometer Alignment See Figures 5.14 and 5.15 for alignment using a universal goniometer. 1. Center fulcrum of the goniometer over the lateral epicondyle of the humerus. 2. Align proximal arm with the lateral midline of the humerus, using the center of the acromion process for reference. 3. Align distal arm with the lateral midline of the radius, using the radial head and radial styloid process for reference.
HHHHH Measurements made easy! “There are actual photographs that show you how to measure various ROM’s. No confusing drawings. just pictures. So helpful. They also do a great job of summarizing the most important tips for each joint (i.e. normal ROM’s, where to place the goni, etc.)” —Online Reviewer FIGURE 5.14 Alignment of the goniometer at the beginning of elbow flexion ROM. The elbow is in as much extension as possible. A towel is placed under the distal humerus to ensure that the supporting surface does not prevent full elbow extension. This individual has about 5 degrees of extension beyond the 0-degree neutral position.
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Upper-Extremity Testing
PART II
FIGURE 5.13 End of elbow flexion ROM. The examiner’s hand stabilizes the humerus, but it must be positioned so it does not limit the motion.
FIGURE 5.14 Alignment of the goniometer at the beginning of elbow flexion ROM. The elbow is in as much extension as possible. A towel is placed under the distal humerus to ensure that the supporting surface does not prevent full elbow extension. This individual has about 5 degrees of extension beyond the 0-degree neutral position. FIGURE 5.14 Alignment of the goniometer at the beginning of elbow flexion ROM. The elbow is in as much extension as possible. A towel is placed under the distal humerus to ensure that the supporting surface does not prevent full elbow extension. This individual has about 5 degrees of extension beyond the 0-degree neutral position.
FIGURE 5.13 End of elbow flexion ROM. The examiner’s hand stabilizes the humerus, but it must be positioned so it does not limit the motion.
FIGURE 5.15 Alignment of the goniometer at the end of elbow flexion ROM. The forearm is kept in full supination so that the greatest amount of elbow flexion can occur. This individual’s flexion ROM would be recorded as 5-0-145°. Alignment of the goniometer at the end of elbow flexion ROM. The forearm is kept in full supination so that the greatest amount of elbow flexion can occur. This individual’s flexion ROM would be recorded as 5-0-145°.
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