Central Concern:

Radio-Capitula joint, common dysfunction and adjustment indications with

appropriate risk management
What is the real problem? Do I have the skills/Knowledge to address the
central concern?
During class last week we were learning about the elbow complex and the joints
which comprise this structure;
 Humeroradial
 Humeroulnar
 Radioulnar
But during some conversations with lecturers I learnt about a fourth joint;
 The Radiocapitella
Which is an articulation of the Capitulum of the Humerus and Head of the Radius
through;
 Flexion/Extension of Elbow
 Pronation/Supination of Wrist
As I started doing some research into this joint it became immediately apparent that
it is not commonly discussed in relation to joints of the elbow, I believe this is due to
injuries sustained at this joint are caused by Trauma (such as falling onto hands with
forced extension) and associated with Athletic movements such as overhead
throwing motions and Axial loading through weightbearing sports which can increase
axial and shear stress to the lateral elbow and Radiocapitellar joint (Hsu et al., 2011)
Bergmann and Vizniak did not have much to offer from our course material for the
gross anatomy of the area but did have some great adjustments for movement of the
Radial head over the Ulna either Anteriorly or Posteriorly (Vizniak, 2018).
Bergmann also drew attention to the Elbow being a source of referral pain or the site
of referral pain in relation to the Wrist, Shoulder and Neck structures when looking to
diagnose pain (Bergmann and Peterson, 2011).
Another associated disorder with the Radiocapitellar joint was Oesteochondritis
Dessecans (OCD) whereby the articular cartilage separates from subchondral bone
usually of the Capitulum in the Elbow complex due to repetitive stress from sports
usually in adolescents (van Bergen et al., 2016).

Where do I find the information I need? Can I trust the new information
source?
Continued discussions with Lecturers and eventually research into common sporting
injuries that I associate myself with in practice once graduated.
Do I need a team approach to this? Who do I recruit into my management
team?
Yes, I do, I do not have the knowledge by myself. I need to research and ask
questions of those who have had experience with this joint and its conditions to be
able to treat effectively.
How can I be sure this new approach has addressed the central concern or
resulted in a positive change - outcomes..
Well it certainly piqued my interest and got me exploring. I have not finished with this
subject but am happy with the knowledge gained so far.
Apply my renewed approach next time around.
References:
Hsu, S., Moen, T., Levine, W. and Ahmad, C. (2011). Physical Examination of the
Athlete’s Elbow. The American Journal of Sports Medicine, 40(3), pp.699-708.
Bergmann, T. and Peterson, D. (2011). Chiropractic technique. St. Louis, Mo.:
Mosby/Elsevier, p.320.
Vizniak, N. (2018). Evidence informed joint-play and mobilization. [Canada]:
Professional Health Systems Inc., p.281.
van Bergen, C., van den Ende, K., ten Brinke, B. and Eygendaal, D. (2016).
Osteochondritis dissecans of the capitellum in adolescents. World Journal of
Orthopedics, 7(2), p.102.