Magnetic Resonance Imaging versus Electrophysiologic Tests in Clinical Diagnosis of Lower Extremity Radicular Pain.

E G Hasankhani,F Omidi-Kashani

doi:10.1155/2013/952570

Abstract

Introduction. Radicular low back pain is one of the most common medical problems. The aim of this study was to evaluate the diagnostic accuracy of MRI and electrodiagnosis in lower extremity radicular pain in relation to history and clinical findings. Methods. In this cross-sectional study, we studied 165 sciatalgic subjects. A comprehensive history and physical examinations were taken from the subjects and recorded, and then MRI scanning and electrodiagnostic (nerve conduction velocity and electromyography) tests were performed. Results. From 152 subjects who remained in the study, 67 cases (44.1%) had radicular pain in left lower limb, 46 (30.3%) in right, and 39 (25.6%) in both lower limbs. 104 cases (68.4%) had shown some type of abnormalities in both MRI and electrodiagnosis, 30 (19.7%) had shown this abnormality only in MRI, and 21 (13.8%) only in electrodiagnosis, while 10 cases (6.5%) had both normal MRI and electrodiagnostic studies. Coordination rates of MRI and electrodiagnosis with clinical findings were 58.6% and 89.5%, respectively. Conclusion. In many MRI negative but symptomatic subjects, electrodiagnosis has an important diagnostic value.

Highlights

Radicular low back pain is one of the most common medical problems. e aim of this study was to evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) and electrodiagnosis in lower extremity radicular pain in relation to history and clinical ndings
Disc herniation in MRI scanning of the asymptomatic patients is a very common nding and decision for surgery based on only MRI ndings is not justi ed [9]
As our study showed in the patients with lower extremity radicular pain the high concordance of electrodiagnosis with nal clinical diagnosis (89.5% relative to 58.6% in MRI scanning) indicated the high accuracy of this modality in these patients

Summary

Introduction

Radicular low back pain is one of the most common medical problems. e aim of this study was to evaluate the diagnostic accuracy of MRI and electrodiagnosis in lower extremity radicular pain in relation to history and clinical ndings. E aim of this study was to evaluate the diagnostic accuracy of MRI and electrodiagnosis in lower extremity radicular pain in relation to history and clinical ndings. Radicular low back pain is one of the most common medical problems that cause decreased work competence and a heavy cost. Accurate diagnosis of this radicular pain has a paramount important role in proper treatment planning [1]. History taking and physical examination are the rst steps in diagnosis of lower extremity radicular pain [2]. Despite the accuracy of the history, physical examination and MRI in the lower extremity radicular pain, in some cases for more accurate diagnosis, other diagnostic measures are needed. Electrodiagnostic tests can especially provide useful information about the exact location of the nerve damage [5]

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Conclusion