Diagnostic accuracy study of clinical evaluation with MRI findings in patients with radiculopathy due to lumbar disc herniation

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D. K. R. A. K. Y. L. T. S. A. Dr. Munis Ashraf*, “Diagnostic accuracy study of clinical evaluation with MRI findings in patients with radiculopathy due to lumbar disc herniation”, ijmhs, vol. 9, no. 5, pp. 417–423, May 2019.
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Abstract

Background:
Lumbar radiculopathy presents a clinical challenge among primary care
clinicians in both assessment and diagnosis. This often leads to misdiagnosis
and inappropriate treatment of patients resulting in poor health outcomes,
exacerbating this debilitating condition.
Methodology:
51 consecutive patients presenting with low backache were included in the
study. the selected clinical evaluation parameters were then correlated with
MRI findings and their accuracy was calculated using sensitivity, specificity,
positive likelihood ratio, negative likelihood ratio, positive predictive value,
and negative predictive value.
Result:
The study demonstrates that certain clinical parameters are having fairly
good accuracy in diagnosing lumbar radiculopathy.
Key words: Lumbar radiculopathy, diagnostic accuracy, clinical evaluation.

KEYWORDS:

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References

[1] Scharfer A, Hall T, Briffa K. Classification of low back-related leg pain—A proposed patho-mechanism-based approach. Man Ther. 2007;14(2):222-30. [2] Lee-Robinson A, Lee AT. Clinical and Diagnostic Findings in Patients with Lumbar Radiculopathy and Polyneuropathy. Am J Clin Med. 2010;7(2):80-5. [3] Van Boxem K, Cheng J, Patijn J, van Kleef M, Lataster M, Mekhail N, Van Zundert J. Lumbosacral Radicular Pain. Pain Pract. 2010;10(4):339–58. [4] Tachihara H, Kikuchi S, Konno S, Sekiguchi M. Does Facet Joint Inflammation Induce Radiculopathy? An Investigation Using a Rat Model of Lumbar Facet Joint Inflammation. Spine J. 2007;32(4):406–12. [5] Jensen, M., Brant-Zawadzki, M., Obuchowski, N., Modic, M., Malkasian, D. and Ross, J. (1994). Magnetic Resonance Imaging of the Lumbar Spine in People without Back Pain. N Engl J Med, 331(2), pp.69-73. [6] Weiner BK, Patel R. The accuracy of MRI in the Detection of LumbarDisc Containment. J Orthop Surg Res. 2008;3(2):46-50. [7] Coster S, de Bruijn FTM, Tavy TLJ. Diagnostic value of history, physical examination and needle electromyography in diagnosing lumbosacral radiculopathy. 2010. J Neurol. 2010;257:332–7. [8] Manchikanti L, et al. Are diagnostic lumbar medial branch blocks valid? Results of 2-year follow-up. Pain Physician. 2003;6(2):147–53. [9] Kreiner DS, Shaffer WO, Baisden J, Gilbert T, Summers J, Toton J, Hwang S, Mendel RR. Evidence-based clinical guidelines for multidisciplinary spine care: Diagnosis and treatment of degenerative lumbar spinal stenosis. Burr Ridge, IL: North American Spine Society. 2011. [10] Vroomen PCAJ, de Krom MCTFM, Wilmink JT, Kester ADM, Knottnerus JA. Diagnostic value of history and physical examination inpatients suspected of sciatica due to disc herniation: A systematic review. J Neurol. 1999;246:899–906. [11] Helfenstein Junior M, Goldenfum MA, Siena C. Occupational low back pain. Revista da Associação Médica Brasileira. 2010;56(5):583-9. [12] oiraudeau , olt , rap , ermanian , ef vre olau , Mayoux Benhamou MA, Revel M. Value of the bell test and the hyperextension test for diagnosis in sciatica associated with disc herniation: comparison with Lasegue's sign and the crossed Lasegue's sign. Rheumatology J. 2001 Apr 1;40(4):460-6. [13] Majlesi J, Togay H, Ünalan H, Toprak S. The sensitivity and specificity of the Slump and the Straight Leg Raising tests in patients with lumbar disc herniation. JCR: Journal of Clinical Rheumatology. 2008 Apr 1;14(2):87-91 [14] Spangfort E V. The lumbar disc herniation. A computer-aided analysis of 2504 operations. Acta Orthop Scand (Suppl 42) 1972. [15] Albeck MJ. A critical assessment of clinical diagnosis of disc herniation in patients with monoradicular sciatica. Acta neurochirurgica J. 1996 Jan 1;138(1):40-44. [16] Verwoerd AJ, Peul WC, Willemsen SP, Koes BW, Vleggeert-Lankamp CL, el Barzouhi A, Luijsterburg PA, Verhagen AP. Diagnostic accuracy of history taking to assess lumbosacral nerve root compression. The Spine Journal. 2014 Sep 1;14(9):2028-37.Innovative Journal of Medical and Health Science, Vol 9 Iss 5, 417–423 (2019) Diagnostic accuracy study of clinical evaluation with MRI findings in patients with radiculopathy due to lumbar disc herniation 423

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References

[1] Scharfer A, Hall T, Briffa K. Classification of low back-related leg pain—A proposed patho-mechanism-based approach. Man Ther. 2007;14(2):222-30.
[2] Lee-Robinson A, Lee AT. Clinical and Diagnostic Findings in Patients with Lumbar Radiculopathy and Polyneuropathy. Am J Clin Med. 2010;7(2):80-5.
[3] Van Boxem K, Cheng J, Patijn J, van Kleef M, Lataster M, Mekhail N, Van Zundert J. Lumbosacral Radicular Pain. Pain Pract. 2010;10(4):339–58.
[4] Tachihara H, Kikuchi S, Konno S, Sekiguchi M. Does Facet Joint Inflammation Induce Radiculopathy? An Investigation Using a Rat Model of Lumbar Facet Joint Inflammation. Spine J. 2007;32(4):406–12.
[5] Jensen, M., Brant-Zawadzki, M., Obuchowski, N., Modic, M., Malkasian, D. and Ross, J. (1994). Magnetic Resonance Imaging of the Lumbar Spine in People without Back Pain. N Engl J Med, 331(2), pp.69-73.
[6] Weiner BK, Patel R. The accuracy of MRI in the Detection of LumbarDisc Containment. J Orthop Surg Res. 2008;3(2):46-50.
[7] Coster S, de Bruijn FTM, Tavy TLJ. Diagnostic value of history, physical examination and needle electromyography in diagnosing lumbosacral radiculopathy. 2010. J Neurol. 2010;257:332–7.
[8] Manchikanti L, et al. Are diagnostic lumbar medial branch blocks valid? Results of 2-year follow-up. Pain Physician. 2003;6(2):147–53. [9] Kreiner DS, Shaffer WO, Baisden J, Gilbert T, Summers J, Toton J, Hwang S, Mendel RR. Evidence-based clinical guidelines for multidisciplinary spine care: Diagnosis and treatment of degenerative lumbar spinal stenosis. Burr Ridge, IL: North American Spine Society. 2011.
[10] Vroomen PCAJ, de Krom MCTFM, Wilmink JT, Kester ADM, Knottnerus JA. Diagnostic value of history and physical examination inpatients suspected of sciatica due to disc herniation: A systematic review. J Neurol. 1999;246:899–906.
[11] Helfenstein Junior M, Goldenfum MA, Siena C. Occupational low back pain. Revista da Associação Médica Brasileira. 2010;56(5):583-9.
[12] oiraudeau , olt , rap , ermanian , ef vre olau , Mayoux Benhamou MA, Revel M. Value of the bell test and the hyperextension test for diagnosis in sciatica associated with disc herniation: comparison with Lasegue's sign and the crossed Lasegue's sign. Rheumatology J. 2001 Apr 1;40(4):460-6.
[13] Majlesi J, Togay H, Ünalan H, Toprak S. The sensitivity and specificity of the Slump and the Straight Leg Raising tests in patients with lumbar disc herniation. JCR: Journal of Clinical Rheumatology. 2008 Apr 1;14(2):87-91
[14] Spangfort E V. The lumbar disc herniation. A computer-aided analysis of 2504 operations. Acta Orthop Scand (Suppl 42) 1972.
[15] Albeck MJ. A critical assessment of clinical diagnosis of disc herniation in patients with monoradicular sciatica. Acta neurochirurgica J. 1996 Jan 1;138(1):40-44.
[16] Verwoerd AJ, Peul WC, Willemsen SP, Koes BW, Vleggeert-Lankamp CL, el Barzouhi A, Luijsterburg PA, Verhagen AP. Diagnostic accuracy of history taking to assess lumbosacral nerve root compression. The Spine Journal. 2014 Sep 1;14(9):2028-37.Innovative Journal of Medical and Health Science, Vol 9 Iss 5, 417–423 (2019)
Diagnostic accuracy study of clinical evaluation with MRI findings in patients with radiculopathy due to lumbar disc herniation 423

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