Active Radiocapitellar Compression Test: Purpose, Technique, and Interpretation

What Is the Active Radiocapitellar Compression Test Used For?

The Active Radiocapitellar Compression Test is a clinical elbow examination used to help identify osteochondritis dissecans (OCD) of the capitellum, a condition in which the cartilage and underlying bone of the outer part of the elbow joint are damaged. It is most often seen in young, overhead, or weight-bearing athletes such as gymnasts and throwers.

How to Perform the Active Radiocapitellar Compression Test

1. Position the elbow. With the elbow in full extension, the examiner applies an axial (compression) load through the forearm, pressing the radial head into the capitellum.
2. Consider 90° flexion. Some clinicians advocate performing the compression with the elbow flexed to 90°. In this position the radiocapitellar joint is in its closed-pack position, which produces greater joint compression.
3. Add active forearm rotation. While the compression is maintained, the patient actively supinates and pronates the forearm.

What Is a Positive Result?

Pain in the lateral compartment of the elbow during compression and forearm rotation is a positive test. A positive result may indicate osteochondritis dissecans of the capitellum, and further assessment, such as imaging (X-ray or MRI), is usually warranted to confirm the diagnosis.