Which two tests are used to assess elbow collateral ligament pathology?

• A. Varus stress test and Valgus stress test
• B. Mills test and Cozens sign
• C. Tinels sign and Wartenberg's test
• D. Pronator teres test and Mills test

Answer: (A)

Elbow stability against sideways forces comes from the collateral ligaments: the medial collateral ligament resists valgus opening on the inner side, while the lateral collateral ligament resists varus opening on the outer side. To evaluate pathology in these ligaments, clinicians use stress tests that reproduce the opening and any accompanying pain or laxity.

The test that places valgus (inward) stress on the elbow specifically assesses the medial collateral ligament. If the ligament is injured or stretched, you’ll often see increased joint opening or medial elbow pain compared with the other elbow. The test that applies varus (outward) stress evaluates the lateral collateral ligament. A positive result shows increased lateral opening or lateral elbow pain, indicating potential LCL pathology.

These two tests are the standard pair for screening elbow collateral ligament injury. The other options target different structures—tennis elbow tendinopathy, ulnar nerve irritation, or other forearm muscle tests—not the collateral ligaments—so they don’t address this specific pathology.