CONCORDANCE OF UPPER LIMB NEURODYNAMIC TESTS WITH MEDICAL EXAMINATION AND MAGNETIC RESONANCE IMAGING IN PATIENTS WITH CERVICAL RADICULOPATHY: A DIAGNOSTIC COHORT STUDY

Objective: The purpose of this study was to investigate the concordance of the upper limb neurodynamic tests (ULNTs) with a chosen reference standard, consisting of medical examination and magnetic resonance imaging (MRI), in patients with cervical radiculopathy. Methods: This diagnostic cohort study included 51 consecutive patients referred to a center for spinal surgery for clinical investigation of cervical and/or arm pain in Sweden during the period of November 2007 to February 2008. The patients were exposed to the 4 different tests of ULNT. One diagnosis based on each of the tests separately and one based on the tests combined were compared with a chosen reference standard consisting of MRI, anamnestic features, and clinical examination. Results: The ULNT (1-3 used combined) had a sensitivity of 0.97 and a specificity of 0.69. The results of ULNT (1-3 used combined) corresponded in 88.2% with the reference standard. Individually, the ULNT 1 (median) showed the highest validity, and ULNT 2b (radial), the lowest. Conclusion: Upper limb neurodynamic test (combined) showed a substantial agreement with findings from medical examination including MRI. These results indicate the importance of ULNT (combined) to complement the clinical examination of patients with radiculopathy.