Evaluating the Patient With Suspected Radiculopathy

Persons with back, neck, and limb symptoms are commonly seen by health care providers. They constitute a major referral population to specialists in electrodiagnostic medicine. The evaluation of these patients involves consideration of both the common and less common disorders. The electrodiagnostic examination with needle electromyography is the most important means of testing for radiculopathy. This test has modest sensitivity but high specificity. It complements imaging of the spine. Electromyography in combination with nerve conduction testing is valuable in excluding entrapment neuropathies and polyneuropathy, conditions that frequently mimic radicular symptoms. A streamlined examination with 6 muscles, 1 of which is the paraspinal, has a high diagnostic yield, yet minimizes patient discomfort and examiner time. This article presents an overview of the electrodiagnostic evaluation for patients with suspected radiculopathy.