Open AccessClinical evaluation versus magnetic resonance imaging findings in patients with radicular arm pain—A pragmatic study
Author(s) -
Redebrandt Henrietta N.,
Brandt Christian,
Hawran Said,
Bendix Tom
Publication year - 2022
Publication title -
health science reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.462
H-Index - 7
ISSN - 2398-8835
DOI - 10.1002/hsr2.589
Subject(s) - medicine , neck pain , radicular pain , magnetic resonance imaging , cervical radiculopathy , nerve root , radiology , cervical nerve , confidence interval , neurological examination , physical examination , lumbar , surgery , cervical spine , pathology , alternative medicine
Objectives Cervical nerve root compression can lead to radiculopathy in the arm. Some studies have reported low accuracy in determining the responsible nerve root in both cervical and lumbar regions. This prospective, observational, pragmatic study aimed to determine the accuracy of the clinical evaluation relative to magnetic resonance imaging (MRI) findings in patients with arm radiculopathy. Methods Patients with neck pain and neck‐related arm pain referred to a spine unit underwent a standard clinical neurological examination and cervical spine MRI. The clinical examination required a judgment of the most likely cervical root involved, including the side. The Interobserver reproducibility was tested. Using MRI, the most likely nerve root involved according to radiology was assessed. Results Eighty‐three patients met the inclusion criteria. The Interobserver reproducibility between clinical evaluators was 58%, with a modest κ coefficient (0.33, 95% confidence interval [CI]: 0.18–0.47) classified only as "fair agreement.” Only 31% (95% CI: 22–42) of the 83 patients exhibited full agreement regarding the suspected cervical root as assessed via the clinical evaluation and MRI. In another 28% (95% CI: 18–39), the clinical evaluation identified an adjacent level to that identified on MRI. Conclusions In cervical radiculopathy, the clinical‐neurological examination diagnosed the same in 31% or an adjacent cervical root in 28% of the patients in relation to the most affected cervical root on MRI.