Concordance of upper limb neurodynamic tests with medical examination and magnetic resonance imaging in patients with cervical radiculopathy: a diagnostic cohort study

J Manipulative Physiol Ther. Nov-Dec 2013;36(9):626-32. doi: 10.1016/j.jmpt.2013.07.007. Epub 2013 Oct 23.

Abstract

Objective: The purpose of this study was to investigate the concordance of the upper limb neurodynamic tests (ULNTs) with a chosen reference standard, consisting of medical examination and magnetic resonance imaging (MRI), in patients with cervical radiculopathy.

Methods: This diagnostic cohort study included 51 consecutive patients referred to a center for spinal surgery for clinical investigation of cervical and/or arm pain in Sweden during the period of November 2007 to February 2008. The patients were exposed to the 4 different tests of ULNT. One diagnosis based on each of the tests separately and one based on the tests combined were compared with a chosen reference standard consisting of MRI, anamnestic features, and clinical examination.

Results: The ULNT (1-3 used combined) had a sensitivity of 0.97 and a specificity of 0.69. The results of ULNT (1-3 used combined) corresponded in 88.2% with the reference standard. Individually, the ULNT 1 (median) showed the highest validity, and ULNT 2b (radial), the lowest.

Conclusion: Upper limb neurodynamic test (combined) showed a substantial agreement with findings from medical examination including MRI. These results indicate the importance of ULNT (combined) to complement the clinical examination of patients with radiculopathy.

Keywords: Brachial Plexus; Cervical Radiculopathy; Magnetic Resonance Imaging; Neurological Examination.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Brachial Plexus Neuropathies / diagnosis*
  • Cohort Studies
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Neurologic Examination / methods
  • Pain Measurement
  • Physical Examination / methods*
  • Preoperative Care / methods
  • ROC Curve
  • Radiculopathy / diagnosis*
  • Radiculopathy / surgery
  • Reference Standards
  • Severity of Illness Index
  • Upper Extremity / physiopathology