Introduce and look around for any aids. Remove top and expose both upper limbs. Ask about pain.

Look
Inspect the elbow joint from front, side and behind for:

• Skin: Scars, skin changes, rheumatoid nodules, psoriatic plaques, swelling
• Muscle: Wasting
• Bone & Joint: Malalignment of bones, deformities (Varus – supracondylar fracture. Valgus – non-union of lateral condylar fracture.)

Feel

• Skin: Temperature, nodules, swelling (soft due to olecranon bursitis, hard due to bony deformity, boggy swelling suggests synovial inflammation e.g. RA),

• Joint: Palpate joint margin, localised tenderness (medial epicondyle=golfers' elbow, lateral epicondyle=tennis elbow)

Move
Active then Passive, assess better side first.
Ask patient to put arms behind their head.
Flexion (0-150°): Upper arm by side move forearm up (pain at medial epicondyle on flexion=golfer’s elbow)
Extension(0-180°): Upper arm by side move forearm down (pain at lateral epicondyle on extension=tennis elbow)
Pronation (0-90°): Elbows tucked in at sides turn palms to the floor.
Supination (0-90°): Elbows tucked in at sides turn palms to the sky.