prolotherapy-elbow

As Seen On...

Elbow


Front
elbow-front

LateralEpichondyleMedialEpichondyleRadialHead
Appearance


Palpation
1. Lateral Epichondyle R L
2. Medial Epichondyle R L
3. Radial Head R L
4. Other
Observed Abnormality? Yes No

Sensation Intact? Yes No

Moves Extremities w/o Deficit? Yes No


Range of Motion

Flexion
FullLimited    LevelPainExplain
Extension
FullLimited    LevelPainExplain
Supination
FullLimited    LevelPainExplain
Pronation
FullLimited    LevelPainExplain


Procedure Note
Consent
Skin Cleaned with Chlohexadine
Other

Tender Points Injected with:Dextrose PRP
Joint Injection:Dextrose PRP Stem Cell


Resolution of Symptoms? Yes No

Tolerated Well? Yes No
Procedural Sedation:
Dose

Dose

Dose