To determine the source of the elbow, wrist and arm pain, the physician will review a medical history and perform a physical examination. The physician will feel the affected areas and assess range of movement and joint stability.  A few conditions (e.g., tennis elbow) may be diagnosed with physical examination only.

The patient may be asked to complete a pain assessment form. To confirm a diagnosis, a physician may order various tests, which may include:

• Imaging tests. These tests produce images of various parts of the body, including organs, tissues, structures and pathways. These tests are useful in revealing the extent of bone fractures or other damage to the joints and tissue and may include:
  
  
• • X-ray. A type of test that uses low doses of radiation to produce images on film or fluorescent screens. X-rays are useful for assessing if bones are broken, fractured or chipped.
    
    
  • MRI (magnetic resonance imaging). A safe and noninvasive or minimally invasive test that uses powerful magnets to produce images on a computer screen and film. It allows a physician to assess damage to the soft tissue structures around a dislocated joint or bone fracture.

• • CAT scan (computed axial tomography). A test that uses an x-ray unit that rotates around the body, and a computer to create cross-sectional images of the inside of the body. It produces more detailed images than a conventional x-ray exam.
    
    
  • Arthrography. A type of x-ray examination of a joint after the injection of a dye (contrast medium) and/or air to outline the soft tissue and joint structures on the images.
    
    
  • Bone scan. A type of radionuclide imaging in which tiny amounts of radioactive materials called tracers are introduced into the body where they emit waves of radiation that are detected by a special gamma camera. The camera produces images that are interpreted by radiologists or nuclear medicine specialists.
    
    A bone scan’s sensitivity to variation in bone metabolism and its ability to scan the entire skeleton makes it very helpful in diagnosing small or hidden (occult) fractures that do not appear on a standard x-ray as well as a wide range of bone disorders (e.g., osteomyelitis, Paget’s disease).
    
    
• Arthroscopy. A physician inserts a scope through a small incision to see within the joint. Arthroscopy can also be used in surgical repair.
  
  
• Electromyography. A physician inserts a thin-needle electrode into the muscles. An instrument records the electrical activity in the muscle at rest and as the patient contracts or moves it. Electromyography and related tests such as nerve conduction velocity (NCV) studies can help evaluate and diagnose muscle and nerve disorders, such as carpal tunnel syndrome.
  
  
• Blood tests. Laboratory analysis of blood samples can help determine if an underlying condition (e.g., rheumatoid arthritis, infection) is causing the pain.
  
  
• Urinalysis. Testing of urine samples can help physicians identify some diseases that may be causing the pain (e.g., lupus, gout). 
  
  
• Joint aspiration and synovial fluid analysis. Joint (synovial) fluid is removed with a syringe and sent to a laboratory for analysis. Conditions such as bursitis and arthritis, as well as many injuries, can cause fluid buildup that result in swelling and pressure.