Purpose: To diagnose patients with cervical radiculopathy so that patient’s can be treated with the appropriate interventions.
Rule:
1. Positive Upper Limb Tension Test A
2. Involved cervical rotation less than 60 degrees
3. Positive Distraction Test
4. Positive Cervical Compression / Spurling’s Test
| Item | 2 + variables | 3+ variables | 4 variables |
| SN | 0.39 | 0.39 | 0.24 |
| SP | 0.56 | 0.94 | 0.99 |
| +LR | 0.88 | 6.10 | 30.3 |
| -LR | |||
| PPV | 21% | 65% | 90% |
| NPV |
SN = sensitivity – ‘SnOut’ helps rule out a disease (higher number is better – >0.9 is excellent)
SP = Specificity – ‘SpIn’ helps rule in a disease (higher number is better – greater than 0.90 is excellent))
+LR = positive likelihood ratio – ratio of positive test results in a patients with the pathology (true positives) higher number is better (> 10 is excellent)
-LR = negative likelihood ratio – ratio of negative test results in a patients with the pathology (false negatives) lower number is better (< 0.1 is excellent)
PPV = positive predictive value – percentage of patients who both test positive & have the disease (true positives)
NPV = negative predictive value – percentage of patients who both test negative & do not have disease (true negatives)
References:
1. Wainner RS, et al. Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy. Spine. 2003; 28(1): 52-62.
2. Waldrop MA. Diagnosis and treatment of cervical radiculopathy using a clinical prediction rule and a multimodal intervention approach: a case series. J Orthop Sports Phys Ther. 2006; 36(3): 152-9.
