Josh is a 34-year-old, left-hand-dominant man who presents with right elbow pain.

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<p>Josh is a 34-year-old, left-hand-dominant man who presents with right elbow pain.</p><p>He reports an injury eight days ago playing rugby league.</p><p>He reports fending off an opposing player, with his right elbow flexed at about 90°, when he heard a pop and felt sharp pain at the anterior elbow.</p><p>There was immediate bruising and pain around the antecubital fossa which settled within a few days with simple analgesia. However, he now has weakness lifting shopping bags, turning doorknobs and opening bottles.</p><p>Josh is generally well with no past history of note.</p><p>On examination right elbow flexion and forearm supination power are reduced, with preserved elbow extension and forearm pronation strength.</p><p>Shoulder strength and range of movement is normal.</p><p>There is a non-tender soft tissue mass in the proximal part of the anterior arm (pictured).</p>

Dr Kate Kelso is a GP and medical editor at Australian Doctor.