Musculoskeletal disorders in referrals for suspected cervical radiculopathy.

Cannon DE, Dillingham TR, Miao H, Andary MT, Pezzin LE. Musculoskeletal disorders in referrals for suspected cervical radiculopathy. Archives of physical medicine and rehabilitation. 2007 Oct 1; 88(10):1256-9.

Related HSR&D Project(s)

• IIR 04-200 – Electrodiagnostic Services: Guidelines, Compliance, and Outcome

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Abstract:

OBJECTIVES: To determine (1) the prevalence of selected common musculoskeletal disorders in patients referred for electrodiagnosis when cervical radiculopathy is suspected and (2) whether these findings predict electrodiagnostic study outcome. DESIGN: Prospective study. SETTING: Electrodiagnostic laboratories in departments of physical medicine and rehabilitation at 5 participating institutions. PARTICIPANTS: A total of 191 subjects undergoing electrodiagnostic evaluations for upper-limb symptoms when cervical radiculopathy was suspected. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Prevalence of certain musculoskeletal disorders (myofascial pain, shoulder impingement, lateral epicondylitis, de Quervain's tenosynovitis) and outcomes of electrodiagnostic testing (normal study, cervical radiculopathy, or another electrodiagnostically confirmed diagnosis). RESULTS: The total prevalence of musculoskeletal disorders was 42%. The prevalence in those with a normal study was 69%, compared with 29% in those with cervical radiculopathy (P < .001) and 45% in those with another diagnosis (P = .02). CONCLUSIONS: Musculoskeletal disorders are common in patients with suspected cervical radiculopathy. Although the presence of certain musculoskeletal disorders makes having a normal electrodiagnostic evaluation significantly more likely, the high prevalence among both patients with normal studies and those with radiculopathy and other disorders limits the usefulness of this information in precisely predicting study outcome. The presence of musculoskeletal disorders should not preclude electrodiagnostic testing when otherwise indicated.