National Physical Therapy Examination (NPTE) Practice Exam

What finding is most consistent with a grade I sprain of the medial collateral ligament of the elbow?

1. Pain with valgus stress testing and minimal instability with the elbow in 60° of flexion

2. Pain with varus stress testing and moderate instability with the elbow in 60° of flexion

3. No pain with valgus stress testing and moderate instability with the elbow in 5° of flexion

4. No pain with varus stress testing and minimal instability with the elbow in 5° of flexion

The correct answer is: Pain with valgus stress testing and minimal instability with the elbow in 60° of flexion

A grade I sprain of the medial collateral ligament (MCL) of the elbow typically involves mild damage to the ligament without significant instability. In this case, the finding of pain with valgus stress testing combined with minimal instability when the elbow is at 60 degrees of flexion aligns well with the characteristics of a grade I sprain. Valgus stress testing assesses the integrity of the MCL by applying a force that pushes the forearm laterally while stabilizing the upper arm. Pain during this test indicates that the ligament is irritated or inflamed, which is consistent with a grade I sprain. However, minimal instability suggests that the ligament is intact enough to maintain some stability, reflecting the less severe nature of a grade I injury. In contrast, the other scenarios presented describe situations that do not fit the typical presentation of a grade I sprain. For instance, moderate instability would be indicative of a more severe injury, such as a grade II or III sprain, where the ligament may be partially or completely torn. Additionally, the presence of no pain during stress testing opposes the expected symptoms associated with an injured ligament.