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Various history and physical examination characteristics predicted nerve root compression

Key Words: magnetic resonance imaging • medical history taking • physical examination

The first 150 words of the full text of this article appear below.

Design
Blinded comparison of history and physical examination characteristics with magnetic resonance (MR) imaging.

Setting
Neurology department of a university hospital in Maastricht, the Netherlands.

Patients
274 patients (mean age 46 y, 51% men) with a new episode of pain radiating into the leg. Exclusion criteria were previous spinal surgery, pregnancy, severe comorbidity, or contraindication to MR imaging.

Description of test and diagnostic standard
Standardised methods were used to assess history and physical characteristics. The diagnostic standard was MR imaging of the lumbar spine within 24 hours after the clinical examination (including MR radiculography).

Main outcome measures
Independent history and physical examination predictors of nerve root compression on MR imaging using multiple logistic regression analysis, and predictive power of diagnostic models.

Main results
56% of MR imaging studies detected root compression. Several history items and physical examination tests independently predicted nerve root compression (table). For a multivariate model including history and physical examination variables, the area under the receiver operating characteristic (ROC) curve . . . [Full text of this article]

Michael Yelland, MBBS

University of Queensland, Herston, Queensland, Australia