The Value of Provocative Tests in Diagnosis of Cervical Radiculopathy

Abstract

• Background: This study was aimed at assessing the accuracy of Provocative Tests in diagnosis of acute or chronic Cervical Radiculopathy (CR) based on an electrodiagnostic reference criterion.
• Materials and Methods: Shoulder Abduction Test (SAT), Spurling Test (ST), Upper Limb Tension Test (ULTT), and electromyography were done on 97 patients who referred to Electrodiagnostic center in the university hospital from January 2010 to March 2011. All of the participants had neck and radicular pain for at least 3 weeks. They were classified according to electrodiagnostic findings. Then diagnostic values of provocative tests were assessed in diagnosis of acute or chronic CR on the basis of reference criterion.
• Results: SAT and ST were more specific (85%) compared to ULTT, while ULTT was more sensitive (60.46% in acute and 35.29% in chronic) than the other two. SAT and ST had a significant accuracy for comparison between acute and chronic CR (P<0.05).
• Conclusion: ULTT is suitable for screening of CR, while SAT and ST can support diagnosis. SAT and ST are good diagnostic tests for comparison between acute and chronic CR.
• Key words: Cervical radiculopathy, Electrodiagnostic study, Shoulder abduction test, Spurling test, Upper limb tension test