Elbow Orthopaedic Test: Cozen’s Test

Cozen's test is a physical examination technique used to assess lateral epicondylalgia, commonly known as tennis elbow. It involves passive wrist extension with the elbow in full extension and forearm pronated, and resisted wrist extension with the elbow in slight flexion and forearm pronated. 

Here is the step-by-step procedure to perform Cozen's test:

1. Ask the patient to sit comfortably and extend their affected arm in front of them with the elbow straight and palm facing down.
2. Stand next to the patient and place your hand on their wrist to stabilize it.
3. Ask the patient to resist while you try to force their wrist into flexion, as if you were trying to push their hand towards the ground. Apply resistance for about 5 seconds.
4. Repeat the test with the patient's elbow slightly bent, around 20-30 degrees, and the forearm still pronated.
5. Observe the patient's reaction and ask if they experienced any pain during the test.
6. Look for any signs of weakness, tenderness, or pain over the lateral epicondyle (bony prominence on the outer part of the elbow) or extensor carpi radialis brevis muscle (located on the outer side of the forearm).

If the patient experiences pain or tenderness over the lateral epicondyle or extensor carpi radialis brevis muscle during the resisted wrist extension test, it may indicate a positive result for lateral epicondylalgia or tennis elbow.

References:

1. Cozen, L. (1959). Epicondylitis: lateral tennis elbow. The Journal of Bone & Joint Surgery, 41(5), 988-997.
2. Bisset, L., Beller, E., Jull, G., Brooks, P., Darnell, R., & Vicenzino, B. (2005). Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ, 329(7475), 1315.
3. Vasseljen, O., & Holten, K. (2014). Acute lateral epicondylalgia: a systematic review. Sports Medicine, 44(3), 433-447.