The Relationship Between History and Physical Examination Findings and the Outcome of Electrodiagnostic Testing in Patients With Sciatica Referred to Physical Therapy

Savage, Nathan J.; Fritz, Julie M.; Thackeray, Anne

doi:10.2519/jospt.2014.5002

Cited by 4 publications

(5 citation statements)

References 36 publications

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“…Furthermore, the negative radiculopathy group had a higher mean than the negative group. Savage et al [59] in their EDX study reported similar data, where the positive group scored 37.2 compared to 43.4 in the negative group. The DN4 questionnaire also did not show significant differences when comparing the positive and negative groups for radiculopathy in our study, similar to the findings of Savage et al [59].…”

Section: Discussionmentioning

confidence: 64%

Comparison of Magnetic Resonance Imaging with Electrodiagnosis in the Evaluation of Lumbosacral Radiculopathy in Patients with Clinical Suspicion of the Pathology

Montaner-Cuello,

Caudevilla-Polo,

Rodríguez-Mena

et al. 2024

Preprint

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(1) Background: The diagnosis of lumbosacral radiculopathy involves anamnesis, assessment of sensitivity and strength, diagnostic imaging—usually magnetic resonance imaging (MRI)—and electrodiagnostic testing (EDX), typically electromyography (EMG) and electroneurography (ENG). MRI evaluates the structures supporting the spinal cord, while EDX evaluates root functionality. The present study aimed to analyze the concordance of MRI and EDX findings in patients with clinically suspected radiculopathy. Additionally, we investigated the comparison between these two reference tests and various clinical variables and questionnaires. (2) Methods: We designed a prospective epidemiological study of consecutive cases with an observational, descriptive, cross-sectional, and double-blind nature following the STROBE guidelines, encompassing 142 patients with clinical suspicion of lumbosacral radiculopathy. (3) Results: Of the sample, 58.5% tested positive for radiculopathy using EDX as the reference test, while 45.8% tested positive using MRI. The comparison between MRI and EDX in the diagnosis of radiculopathy in patients with clinical suspicion was not significant; the overall agreement was 40.8%. Only the years with symptoms were comparatively significant between the positive and negative radiculopathy groups as determined by EDX. (4) Conclusion: The comparison between lumbar radiculopathy diagnoses in patients with clinically suspected pathology using MRI and EDX as diagnostic modalities did not yield statistically significant findings. MRI and EDX are complementary tests assessing different aspects in patients with suspected radiculopathy; degeneration of the structures supporting the spinal cord does not necessarily imply root dysfunction.

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Section: Discussionmentioning

confidence: 64%

Comparison of Magnetic Resonance Imaging with Electrodiagnosis in the Evaluation of Lumbosacral Radiculopathy in Patients with Clinical Suspicion of the Pathology

Montaner-Cuello,

Caudevilla-Polo,

Rodríguez-Mena

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Furthermore, the negative radiculopathy group had a higher mean than the negative group. Savage et al [ 59 ] in their EDX study reported similar data, where the positive group scored 37.2 compared with 43.4 in the negative group. The DN4 questionnaire also did not show significant differences when comparing the positive and negative groups for radiculopathy in our study, similar to the findings of Savage et al [ 59 ].…”

Section: Discussionmentioning

confidence: 67%

Comparison of Magnetic Resonance Imaging with Electrodiagnosis in the Evaluation of Clinical Suspicion of Lumbosacral Radiculopathy

Montaner-Cuello,

Caudevilla-Polo,

Rodríguez-Mena

et al. 2024

Diagnostics

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(1) Background: The diagnosis of lumbosacral radiculopathy involves anamnesis, an assessment of sensitivity and strength, diagnostic imaging—usually magnetic resonance imaging (MRI)—and electrodiagnostic testing (EDX), typically electromyography (EMG), and electroneurography (ENG). MRI evaluates the structures supporting the spinal cord, while EDX evaluates root functionality. The present study aimed to analyze the concordance of MRI and EDX findings in patients with clinically suspected radiculopathy. Additionally, we investigated the comparison between these two reference tests and various clinical variables and questionnaires. (2) Methods: We designed a prospective epidemiological study of consecutive cases with an observational, descriptive, cross-sectional, and double-blind nature following the STROBE guidelines, encompassing 142 patients with clinical suspicion of lumbosacral radiculopathy. (3) Results: Of the sample, 58.5% tested positive for radiculopathy using EDX as the reference test, while 45.8% tested positive using MRI. The comparison between MRI and EDX in the diagnosis of radiculopathy in patients with clinical suspicion was not significant; the overall agreement was 40.8%. Only the years with symptoms were comparatively significant between the positive and negative radiculopathy groups as determined by EDX. (4) Conclusion: The comparison between lumbar radiculopathy diagnoses in patients with clinically suspected pathology using MRI and EDX as diagnostic modalities did not yield statistically significant findings. MRI and EDX are complementary tests assessing different aspects in patients with suspected radiculopathy; degeneration of the structures supporting the spinal cord does not necessarily imply root dysfunction.

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“…Three systematic reviews and 7 clinical studies evaluated methods for diagnosing lumbar radiculopathy. 12,13,15,26,33,43,45,48,50 Scaia et al synthesized evidence from 7 studies, reporting that the SLR demonstrated a wide range of sensitivity from 0.19 to 0.97 and specificity from 0.10 to 0.89, limiting diagnostic utility. 13 Tawa synthesized evidence from 12 studies reporting poor sensitivity of 0.13 to 0.61 for motor tests and sensitivity ranges of 0.14 to 0.67 and specificity of 0.60 to 0.93 for deep tendon reflexes.…”

Section: Radiculopathymentioning

confidence: 99%

“…26 electrodiagnostic testing. 43,50 Petersen et al, in a review of 20 studies, reported sensitivity (0.28-0.50) and specificity (0.83-0.94) for a cluster of 3 or more of 4 findings in the presence of a positive SLR: (1) pain in a dermatomal distribution, (2) corresponding sensory deficit, (3) diminished reflex, and (4) motor weakness. 15 Sensitization.…”

Section: Radiculopathymentioning

confidence: 99%

“…13,15,26 The absence of convincing evidence for diagnostic accuracy is due to several methodological limitations shared by many included studies, most notably by using different methods to conduct or interpret tests, by considering radicular pain and radiculopathy as a singular condition, and by presuming imaging is an adequate reference standard for radiculopathy. 12,13,26,33,43,50,45,48,84 Imaging cannot confirm whether nerve root compression is of sufficient intensity to cause reduced neural signaling, which is the necessary element for radiculopathy. Therefore, participants in studies using imaging confirmation of nerve root compression probably comprise those with radicular pain and those with radiculopathy.…”

Section: Radicular Pain and Radiculopathymentioning

confidence: 99%

See 1 more Smart Citation

Current Evidence for Diagnosis of Common Conditions Causing Low Back Pain: Systematic Review and Standardized Terminology Recommendations

Vining

Shannon

Minkalis

et al. 2019

Journal of Manipulative and Physiological Therapeutics

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Objective: The purpose of this systematic review is to evaluate and summarize current evidence for diagnosis of common conditions causing low back pain and to propose standardized terminology use. Methods: A systematic review of the scientific literature was conducted from inception through December 2018. Electronic databases searched included PubMed, MEDLINE, CINAHL, Cochrane, and Index to Chiropractic Literature. Methodological quality was assessed with the Scottish Intercollegiate Guidelines Network checklists. Results: Of the 3995 articles screened, 36 (8 systematic reviews and 28 individual studies) met final eligibility criteria. Diagnostic criteria for identifying likely discogenic, sacroiliac joint, and zygapophyseal (facet) joint pain are supported by clinical studies using injection-confirmed tissue provocation or anesthetic procedures. Diagnostic criteria for myofascial pain, sensitization (central and peripheral), and radicular pain are supported by expert consensuselevel evidence. Criteria for radiculopathy and neurogenic claudication are supported by studies using combined expert-level consensus and imaging findings. Conclusion: The absence of high-quality, objective, gold-standard diagnostic methods limits the accuracy of current evidence-based criteria and results in few high-quality studies with a low risk of bias in patient selection and reference standard diagnosis. These limitations suggest practitioners should use evidence-based criteria to inform working diagnoses rather than definitive diagnoses for low back pain. To avoid the unnecessary complexity and confusion created by multiple overlapping and nonspecific terms, adopting International Association for the Study of Pain terminology and definitions is recommended.

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The Relationship Between History and Physical Examination Findings and the Outcome of Electrodiagnostic Testing in Patients With Sciatica Referred to Physical Therapy

Cited by 4 publications

References 36 publications

Comparison of Magnetic Resonance Imaging with Electrodiagnosis in the Evaluation of Lumbosacral Radiculopathy in Patients with Clinical Suspicion of the Pathology

Comparison of Magnetic Resonance Imaging with Electrodiagnosis in the Evaluation of Lumbosacral Radiculopathy in Patients with Clinical Suspicion of the Pathology

Comparison of Magnetic Resonance Imaging with Electrodiagnosis in the Evaluation of Clinical Suspicion of Lumbosacral Radiculopathy

Current Evidence for Diagnosis of Common Conditions Causing Low Back Pain: Systematic Review and Standardized Terminology Recommendations

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