Predicting electrodiagnostic outcome in patients with upper limb symptoms: Are the history and physical examination helpful?
| Autor: | Timothy R. Dillingham, Shashi Kumar, Tamara D. Lauder, Steven Shannon, Liliana E. Pezzin, Michael T. Andary, Ronald T. Stephens |
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| Rok vydání: | 2000 |
| Předmět: |
medicine.medical_specialty
Weakness education.field_of_study medicine.diagnostic_test business.industry Rehabilitation Population Physical Therapy Sports Therapy and Rehabilitation Physical examination Electromyography medicine.anatomical_structure Physical therapy Medicine Upper limb Medical history medicine.symptom Radiculopathies business Prospective cohort study education |
| Zdroj: | Archives of Physical Medicine and Rehabilitation. 81:436-441 |
| ISSN: | 0003-9993 |
| DOI: | 10.1053/mr.2000.4426 |
| Popis: | Lauder TD, Dillingham TR, Andary M, Kumar S, Pezzin LE, Stephens RT, Shannon S. Predicting electrodiagnostic outcome in patients with upper limb symptoms: are the history and physical examination helpful? Arch Phys Med Rehabil 2000;81:436-41. Objective: To determine the effectiveness of medical history and physical examination in predicting electrodiagnostic outcome in patients with suspected cervical radiculopathy. Methods: Data on 183 subjects prospectively collected at five different electrodiagnostic laboratories were analyzed (96 cervical radiculopathies, 45 normal studies, and 42 abnormal electrodiagnostic findings other than radiculopathy). The sensitivity, specificity, positive predictive value, negative predictive value, and odds ratios were determined for symptoms and neurologic signs. Results: Symptoms of numbness, weakness, and tingling were associated with twice the probability of having abnormal electrodiagnostic study results in general, yet were not helpful in identifying a cervical radiculopathy. All single and combined physical examination components had poor sensitivities, with the exception of weakness, but much higher specificities. Patients with either weakness or reduced reflexes on physical examination were up to five times more likely to have abnormal electrodiagnostic findings. In subjects with any abnormal neurologic sign, the sensitivity improved to 84%, the positive predictive value was 79%, but the specificity was low (44%). Of those subjects with normal physical examination results, almost one half had an abnormal electrodiagnostic study result (negative predictive value 52%). Conclusions: In a population of patients with suspected cervical radiculopathy, medical history and physical examination are helpful yet not sufficient to predict the electrodiagnostic outcome. © 2000 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation |
| Databáze: | OpenAIRE |
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