The nightmare of challenging upper thoracic limb lameness is tackled with the discussion of which is the joint affected…. elbow or shoulder?... or both?. The inconsistency of shoulder pathology along with the rising tide of elbow dysplasia patients of all types make answering the shelbow question a real and often frustrating challenge that we all need help with. The gait characteristics, examination techniques, clinical findings and diagnostic techniques of choice will be discussed. The common pathologies and current treatment modalities will be explored. The confounding presence of concurrent primary and secondary radial nerve tract neuropathic pain will also be addressed.