The lateral elbow compartment encompasses the radiohumeral joint between the radial head and the capitulum, bounded medially by the common synovial cavity and laterally by the radial collateral ligament complex and the anconeus. It transmits axial load from the forearm to the distal humerus during grip and weight-bearing activities.
The lateral compartment is the site of radiocapitellar arthrosis, osteochondritis dissecans of the capitulum, radial head fractures, and loose bodies in young throwers. Lateral elbow pain with resisted wrist extension suggests lateral epicondyle pathology, while pain with pronation and supination against resistance implicates the radiohumeral joint. Elbow arthroscopy accesses the lateral compartment via the anterolateral and direct lateral portals. Lateral ulnar collateral ligament incompetence allows the lateral compartment to subluxate (posterolateral rotatory instability).
Avascular subchondral injury of the lateral radiohumeral compartment in adolescent throwers producing lateral elbow pain, locking from loose bodies, and extension loss requiring arthroscopic debridement or fixation.
Lateral ulnar collateral ligament deficiency allowing the lateral elbow compartment to pivot open during supination-axial load, producing a positive lateral pivot-shift test and symptomatic elbow subluxation.
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