title: Concordance of upper limb neurodynamic tests with medical examination and magnetic resonance imaging in patients with cervical radiculopathy: a diagnostic cohort study.
abstract: OBJECTIVE
  The purpose of this study was to investigate the concordance of the upper limb neurodynamic tests (ULNTs) with a chosen reference standard, consisting of medical examination and magnetic resonance imaging (MRI), in patients with cervical radiculopathy.
  
  
  METHODS
  This diagnostic cohort study included 51 consecutive patients referred to a center for spinal surgery for clinical investigation of cervical and/or arm pain in Sweden during the period of November 2007 to February 2008. The patients were exposed to the 4 different tests of ULNT. One diagnosis based on each of the tests separately and one based on the tests combined were compared with a chosen reference standard consisting of MRI, anamnestic features, and clinical examination.
  
  
  RESULTS
  The ULNT (1-3 used combined) had a sensitivity of 0.97 and a specificity of 0.69. The results of ULNT (1-3 used combined) corresponded in 88.2% with the reference standard. Individually, the ULNT 1 (median) showed the highest validity, and ULNT 2b (radial), the lowest.
  
  
  CONCLUSIONS
  Upper limb neurodynamic test (combined) showed a substantial agreement with findings from medical examination including MRI. These results indicate the importance of ULNT (combined) to complement the clinical examination of patients with radiculopathy.
authors.affiliation: Doctor of Naprapathy, Scandinavian College of Naprapathic Manual Medicine Kräftriket, Stockholm, Sweden.
authors.forename: Martina
authors.initials: M
authors.lastname: Apelby-Albrecht
authors.forename: Linda
authors.initials: L
authors.lastname: Andersson
authors.forename: Ingrid W
authors.initials: IW
authors.lastname: Kleiva
authors.forename: Kristian
authors.initials: K
authors.lastname: Kvåle
authors.forename: Eva
authors.initials: E
authors.lastname: Skillgate
authors.forename: Anna
authors.initials: A
authors.lastname: Josephson
mesh_terms: D000328:Adult; D000368:Aged; D020516:Brachial Plexus Neuropathies / Q000175:diagnosis*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000379:methods; D010147:Pain Measurement; D010808:Physical Examination / Q000379:methods*; D011300:Preoperative Care / Q000379:methods; D012372:ROC Curve; D011843:Radiculopathy / Q000175:diagnosis* / Q000601:surgery; D012015:Reference Standards; D012720:Severity of Illness Index; D034941:Upper Extremity / Q000503:physiopathology
keywords: Brachial Plexus; Cervical Radiculopathy; Magnetic Resonance Imaging; Neurological Examination