wash hands 
speack with patient – ? pain 
gain consent after explaining the procedurs
Look / inspection   – 
swelling, scars, skin changes , wasting or deformity 
Feel – Palpate – 
joint line by the sides of olecranone – 
then the lateral and medial epicondile  – look for tenderness 
Move – 
Range of motion – 
passovely – flex and extend actively (look at angals ) +pronation and supination 
Actively – 
then against pressure ( hold the elbow)
check for lateral epicondilitis  – with wrist flexion and extention )  
lateral epicondilitis 
Medial epicondilitis 
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