CPR for Cervical Radiculopathy: Difference between revisions

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 The following criteria are considered predictive of the presence of cervical radiculopathy:  positive upper limb tension test A (ULTTa), involved-side cervical rotation range of motion less than 60 degrees, positive distraction test, and positive Spurling's test A.  Definitions of posititive provocative test results are as follows:  
 The following criteria are considered predictive of the presence of cervical radiculopathy:  positive upper limb tension test A (ULTTa), involved-side cervical rotation range of motion less than 60 degrees, positive distraction test, and positive Spurling's test A.  Definitions of posititive provocative test results are as follows:  


1.&nbsp;<u>ULTTa</u>: Any one of the following:&nbsp; A) symptom reproduction; B) side-to-side difference &gt;10 degrees in in elbow extension; or C) with regard to involved/painful side, ipsilateral neck lateral flexion decreases symptoms and/or contralateral neck lateral flexion increases symptoms.
1.&nbsp;<u>ULTTa</u>: Any one of the following:&nbsp; A) symptom reproduction; B) side-to-side difference &gt;10 degrees in in elbow extension; or C) with regard to involved/painful side, ipsilateral neck lateral flexion decreases symptoms and/or contralateral neck lateral flexion increases symptoms.  


2. <u>Distraction test</u>:&nbsp; symptom reduction.
2. <u>Distraction test</u>:&nbsp; symptom reduction.  


3.&nbsp;<u>Spurling's A</u>:&nbsp; symptom reproduction.
3.&nbsp;<u>Spurling's A</u>:&nbsp; symptom reproduction.  


&nbsp;Clinical values of results are as follows:
&nbsp;Clinical values of results are as follows:  


{| style="width: 686px; height: 87px" cellspacing="1" cellpadding="1" width="686" border="1"
{| style="width: 686px; height: 87px" cellspacing="1" cellpadding="1" width="686" border="1"
|-
|-
| &nbsp;&nbsp;&nbsp; <u>Number of Positive Criteria</u>
| &nbsp;&nbsp;&nbsp; <u>Number of Positive Criteria</u>  
| &nbsp; <u>Sensitivity (95% CI)</u>
| &nbsp; <u>Sensitivity (95% CI)</u>  
| &nbsp; <u>Specificity (95% CI)</u>
| &nbsp; <u>Specificity (95% CI)</u>  
| &nbsp;&nbsp; <u>Positive LR</u>
| &nbsp;&nbsp; <u>Positive LR</u>  
| &nbsp;<u>Negative LR</u>*
| &nbsp;<u>Negative LR</u>*
|-
|-
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Two
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Two  
| &nbsp;&nbsp;&nbsp;&nbsp; 0.39 (0.16-0.61)
| &nbsp;&nbsp;&nbsp;&nbsp; 0.39 (0.16-0.61)  
| &nbsp;&nbsp; &nbsp; 0.56 (0.43-0.68)
| &nbsp;&nbsp; &nbsp; 0.56 (0.43-0.68)  
| &nbsp;&nbsp; 0.88 (1.5-2.5)
| &nbsp;&nbsp; 0.88 (1.5-2.5)  
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 1.09
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 1.09
|-
|-
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp; Three
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp; Three  
| &nbsp;&nbsp;&nbsp;&nbsp; 0.39 (0.16-0.61)
| &nbsp;&nbsp;&nbsp;&nbsp; 0.39 (0.16-0.61)  
| &nbsp;&nbsp;&nbsp; &nbsp;0.94 (0.88-1.0)
| &nbsp;&nbsp;&nbsp; &nbsp;0.94 (0.88-1.0)  
| &nbsp;&nbsp; 6.1 (2.0-18.6)
| &nbsp;&nbsp; 6.1 (2.0-18.6)  
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 0.65
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 0.65
|-
|-
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Four
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Four  
| &nbsp;&nbsp;&nbsp;&nbsp; 0.24 (0.05-0.43)
| &nbsp;&nbsp;&nbsp;&nbsp; 0.24 (0.05-0.43)  
| &nbsp;&nbsp;&nbsp; &nbsp;0.99 (0.97-1.0)
| &nbsp;&nbsp;&nbsp; &nbsp;0.99 (0.97-1.0)  
| &nbsp; 30.3 (1.7-538.2)
| &nbsp; 30.3 (1.7-538.2)  
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 0.77
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 0.77
|}
|}


&nbsp;(Table adapted from Wainner et al 2003.)
&nbsp;(Table adapted from Wainner et al 2003.&nbsp; *Calculated from Sn and Sp values provided in Wainner et al 2003.)


== Evidence<br>  ==
== Evidence<br>  ==

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Purpose
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 To assist in ruling in or out the diagnosis of cervical radiculopathy.

The Rule
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 The following criteria are considered predictive of the presence of cervical radiculopathy:  positive upper limb tension test A (ULTTa), involved-side cervical rotation range of motion less than 60 degrees, positive distraction test, and positive Spurling's test A.  Definitions of posititive provocative test results are as follows:

1. ULTTa: Any one of the following:  A) symptom reproduction; B) side-to-side difference >10 degrees in in elbow extension; or C) with regard to involved/painful side, ipsilateral neck lateral flexion decreases symptoms and/or contralateral neck lateral flexion increases symptoms.

2. Distraction test:  symptom reduction.

3. Spurling's A:  symptom reproduction.

 Clinical values of results are as follows:

    Number of Positive Criteria   Sensitivity (95% CI)   Specificity (95% CI)    Positive LR  Negative LR*
                   Two      0.39 (0.16-0.61)      0.56 (0.43-0.68)    0.88 (1.5-2.5)       1.09
                  Three      0.39 (0.16-0.61)      0.94 (0.88-1.0)    6.1 (2.0-18.6)       0.65
                  Four      0.24 (0.05-0.43)      0.99 (0.97-1.0)   30.3 (1.7-538.2)       0.77

 (Table adapted from Wainner et al 2003.  *Calculated from Sn and Sp values provided in Wainner et al 2003.)

Evidence
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References[edit | edit source]

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