Elbow Orthopaedic Test: Maudsley's Test

Maudsley's test is a physical examination maneuver used to evaluate for the presence of lateral epicondylitis, commonly known as "tennis elbow." It is named after the British orthopedic surgeon, Harry Maudsley, who first described the test.

Procedure:

1. Ask the patient to sit or stand with their arm fully extended and their palm facing downwards.
2. Instruct the patient to extend their wrist against resistance by pushing their hand up towards the ceiling.
3. Apply pressure on the dorsal aspect of the patient's hand with your other hand, resisting the wrist extension movement.
4. Ask the patient to maintain the wrist extension position against the resistance applied by you.
5. Observe the patient's response to the test. A positive result is indicated by pain or tenderness at the lateral epicondyle of the elbow during wrist extension.

A positive Maudsley's test is indicated by pain or tenderness at the lateral epicondyle of the elbow during wrist extension against resistance.

The sensitivity and specificity of Maudsley's test have not been clearly established. However, studies have shown that it has a high positive predictive value, which means that a positive test result is highly indicative of lateral epicondylitis.

References:

1. Maffulli N, Longo UG, Loppini M, Denaro V. Tennis elbow. Journal of orthopaedic trauma. 2018;32:S8-S11.
2. Kwon BC, Kwon YW, Bae SH, Lee JW. Sonographic evaluation of lateral epicondylitis before and after conservative treatment. Journal of ultrasound in medicine. 2013;32:2033-9.
3. Seng C, Mohd Ali M, Singh H, et al. Clinical tests for shoulder and elbow disorders: a systematic review and meta-analysis of diagnostic test accuracy. BMJ Open. 2019;9:e030711.