Abstract Details

Title Sensitivity and Specificity of MRI and EMG in Diagnosing Clinically Evident Cervical Radiculopathy: A Retrospective Study

Topic Clinical Neurophysiology

Presentation(s) P02 - (-)

Poster/Presentation
Number 224

Objective

Background BACKGROUND: Cervical radiculopathy (CR) can be caused by structural or non structural abnormalities.MRI cervical spine (MRIC) can detect structural causes and EMG/NCS (EDX) can detect CR in the presence of a normal imaging study although limited by the timing of the study and the number of muscles sampled.

Design/Methods DESIGN/METHODS: This is a retrospective chart review of all consecutive patients (2007-2009,age>18) referred to the EMG lab for the evaluation of CR and who had MRIC.The patients had to have at least 4 of the following for at least 3 weeks to have 'clinically positive CR': muscle spasm,weakness, paresthesias/numbness,positive Spurling test,and depressed reflexes.EDX was done between 4 weeks and 18 months from symptom onset.Chi square analysis was used to assess the significance of the association between clinically positive CR,MRI positive CR,and EDX positive CR and the sensitivity/specificity of MRIC and EDX in diagnosing the clinically positive CR was calculated.

Results RESULTS: 131 patients (age:53.6;male:70 female:61;Caucasian:70% Hispanics:28%) were included.Pain in a radicular distribution was seen in 89% followed by numbness 71%, weakness in myotomal distribution in 37% and absent reflexes in 23%.50 (38%) were clinically positive,43 (33%) MRI positive,38(29%) EDX positive.88% of those who were clinically positive were also MRI positive and only 44% of those who were clinically positive were EDX positive.There is a significant association between MRI Positive and Clinically Positive ([chi]2 = 68.4,p < 0.001).No significant association was found between EDX Positive and Clinically Positive ([chi]2 = 0.98,p > 0.05).The sensitivity of MRIC in diagnosing a clinically positive CR is 76% and specificity is 93% where as the sensitivity of EDX is 34% and specificity is 74%.

Conclusions CONCLUSIONS: MRI of the cervical spine is more sensitive and specific than EDX in confirming a clinically evident cervical radiculopathy.

Authors/Disclosures
Raghav Govindarajan, MD, FAAN (HSHS St. Elizabeth Medical Group) PRESENTER	Dr. Govindarajan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MT pharma. Dr. Govindarajan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Govindarajan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Argenx. Dr. Govindarajan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Catalyst. Dr. Govindarajan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche . Dr. Govindarajan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sarepta. Dr. Govindarajan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amicus. Dr. Govindarajan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. Dr. Govindarajan has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alexion. Dr. Govindarajan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for MT pharma . Dr. Govindarajan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Catalyst. Dr. Govindarajan has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Argenx. Dr. Govindarajan has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biohaven. Dr. Govindarajan has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for UCB. Dr. Govindarajan has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Takeda. Dr. Govindarajan has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Abbvie. The institution of Dr. Govindarajan has received research support from Band of Hope . The institution of Dr. Govindarajan has received research support from Alexion. Dr. Govindarajan has received publishing royalties from a publication relating to health care.
David S. Goldstein, MD, PhD (National Institutes of Health)	Dr. Goldstein has received publishing royalties from a publication relating to health care.
Channa Kolb, MD	No disclosure on file
Efrain D. Salgado, MD (Cleveland Clinic Florida)	Dr. Salgado has nothing to disclose.

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