Elbow
Epicondylitis (Lateral)
Evidence: suggestive
Mill's Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Diagnosing Lateral Epicondylitis (Tennis Elbow) via passive stretching.
How to Perform
- Position: Patient sits comfortably.
- Action: Examiner palpates the lateral epicondyle.
- Movement: Passively pronate the forearm, fully flex the wrist, and extend the elbow.
Interpretation of Results
- Positive Test: Pain over the lateral epicondyle insertion due to stretching of the Extensor Carpi Radialis Brevis.
Diagnostic Accuracy
- Sensitivity: 53%
- Specificity: 100%
Clinical Context & Limitations
The Mill's Test should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Elbow region, combining the Mill's Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
