looks fine to me... much of it is personal preference anyways, i'm a little taller and use a 4 1/2 (just to give u some idea). as long as it dont slip around or find yourself gripping tighter should be ok. perhaps cuz i have more of an eastern grip i prefer a lil bigger, i notice SW grippers usually dont mind smaller esp since its the current trend for supposed increase bat speed but i dont feel the benefit or comfort.
The grip looks fine the hand is too small. Sorry I had to say that. Here is a picture of my grip. It is a 4 1/2 grip with a heat shrink tube and overwrap. Comes to almost a 4 3/4 grip.
I don't have any elbow problems and never have except when I first started for a while.
My grip is similar to Irvin's picture and I have never experienced wrist or elbow pain. Your grip does look too large to me, and is definitely not too small.