Cervical radiculopathy diagnosis

see also Cervical disc herniation diagnosis.

Lower motor neuron findings:

Weakness usually in one myotome group on one side.

Muscle bulk and tone: atrophy and fasciculations, may be present.

Sensation:

With nerve root compression, sensory loss will follow a dermatomal pattern.

Muscle stretch reflexes

Reproduction of radicular symptoms with axial loading of the head.

Examination may reveal sensory or motor disturbance in a dermatomal/myotomal distribution. Neural compression and tension signs may be positive. Diagnostic tests include imaging and electrodiagnostic study. Electrodiagnostic study serves as an extension of the neurologic examination. Electrodiagnostic findings can be useful for patients with atypical symptoms, potential pain-mediated weakness, and nonfocal imaging findings ¹⁾.

The most common examination findings are painful neck movements and muscle spasm. Diminished deep tendon reflexes, particularly of the triceps, are the most common neurologic finding.

see Spurling's test.

Shoulder abduction test, and upper limb tension test can be used to confirm the diagnosis. Imaging is not required unless there is a history of trauma, persistent symptoms, or red flags for malignancy, myelopathy, or abscess.

Useful sign in evaluating cervical radiculopathy:

Neck extension usually agravates pain when cervical disc disease is present (a minority exhibit pain with flexion).

Abduction relief sign with the shoulder abduction test (some patients find relief).

Lhermittes sign may be present.

see Electrodiagnosis of cervical radiculopathy.

Signs useful in evaluating cervical radiculopathy