[Physio Explained] Differential diagnosis of cervical radiculopathy with Dr Erik Thoomes
Jul 3, 2024
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Dr Erik Thoomes discusses differential diagnosis of cervical radiculopathy, provocation tests, and patient reported outcome measures. The podcast explores distinguishing radiculopathy from somatic neck pain, personalized physiotherapy, and an expert masterclass on diagnosis and management.
Differential diagnosis helps prognosis and management plans, requiring medical tests for specific causes like fractures or tumors.
Provocative tests like Spurling's test and upper limb neural tension tests offer high specificity and sensitivity for accurate diagnosis of cervical radiculopathy.
Deep dives
Importance of Differential Diagnosis in Cervical Radiculopathy
Differential diagnosis between cervical radiculopathy and somatic radiating neck pain is crucial as it affects prognosis and management plans. While non-specific neck pain often lacks a nociceptive source, specific causes like fractures or tumors require medical tests for diagnosis. Cervical radiculopathy, though serious, has a good prognosis with targeted conservative management, usually leading to recovery within four to eight months.
Role of Provocative Tests in Diagnosis
In diagnosing cervical radiculopathy, a thorough history-taking is essential as a diagnostic tool. Provocative tests like Spurling's test and upper limb neural tension tests play a significant role in corroborating hypotheses derived from history and physical examinations. These tests offer high specificity and sensitivity, providing a valuable cluster of tests for accurate diagnosis.
Utilization of Patient-Reported Outcome Measures
Patient-reported outcome measures (PROMs) assess patients' experiences, functional status, and quality of life, aiding in determining the effectiveness of care from the patient's perspective. PROMs, such as the patient-specific functional scale, allow patients to identify their top three disabling activities, facilitating targeted treatment plans. The patient-specific functional scale proves beneficial in engaging patients in their care and aligning treatment goals with patient priorities.
In this episode with Dr Erik Thoomes, we discuss the differential diagnosis of cervical radiculopathy from somatic neck pain, the best provocation tests to use for ruling in cervical radiculopathy, the usefulness of the upper limb tension tests and patient reported outcome measures you can use with this patient population.
Want to learn more about cervical radiculopathy? Erik recently did a brilliant Masterclass with us, called “Expert Approaches to Cervical Radiculopathy” where he goes into further depth on the assessment, treatment and differential diagnosis of cervical radiculopathy.
Dr Erik Thoomes clinical as well as his research interests lie in helping patients manage their spinally related dysfunctions and pain. He has taught both physiotherapy undergraduates as well as post-graduate manipulative physical therapy students, with a special interest in clinical reasoning and motor control dysfunction and he still teaches CPD courses nationally and internationally. Erik has also just completed his PhD.
If you like the podcast, it would mean the world if you're happy to leave us a rating or a review. It really helps!
Our host is @James_Armstrong_Physio
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