A 4-Year-Old Child Who Could Not Supinate Her Forearm

Sanjeev Tuli, MD; Maria Kelly, MD; Kathleen Ryan, MD; Sonal Tuli, MD; Beverly P. Giordano, MS, RN, CPNP, PMHS


J Pediatr Health Care. 2014;28(4):357-360. 

In This Article


Many children with RUS compensate for lost forearm rotation by increasing rotation through the radiocarpal and intercarpal joints, and thus accurate evaluation of forearm versus hand position in supination and pronation is important in detecting RUS. Range of motion assessment should be part of the physical examination for every well child check to allow for early detection of RUS.

Although it occurs rarely, RUS is the most common congenital functional disorder of the elbow joint. RUS is usually an isolated defect but may be associated with abnormalities of other body systems and may be part of a clinical syndrome. Because most children with RUS are not treated surgically, primary care providers are responsible for monitoring function and compensatory mechanisms, evaluating any reports of elbow pain, and ensuring that the patient has no accompanying systemic abnormalities.