Diagnostic accuracy of the neurological upper limb examination II: relation to symptoms of patterns of findings

BMC Neurology
Jørgen R JepsenAnders I Larsen

Abstract

In a sample of patients in clinical occupational medicine we have demonstrated that an upper limb neurological examination can reliably identify patterns of findings suggesting upper limb focal neuropathies. This further study aimed at approaching the diagnostic accuracy of the examination. 82 limbs were semi-quantitatively assessed by two blinded examiners (strength in 14 individual muscles, sensibility in 7 homonymous territories, and mechanosensitivity at 10 locations along nerves). Based on the topography of nerves and their muscular and sensory innervation we defined 10 neurological patterns each suggesting a localized nerve affliction. Information on complaints (pain, weakness and/or numbness/tingling) collected by others served as a reference for comparison. The relation between the presence of pattern(s) and complaints was assessed by kappa-statistics. Sensitivity, specificity, and positive/negative predictive values were calculated, and pre-test odds were compared to post-test probability. The two examiners identified pattern(s) suggesting focal neuropathy in 34/36 out of 38 symptomatic limbs, respectively (kappa = 0.70/0.75), with agreement in 28 limbs. Out of 44 non-symptomatic limbs the examiners agreed on absence o...Continue Reading

References

Jan 1, 1991·American Journal of Industrial Medicine·A ToomingasS Kihlberg
Jun 1, 1983·Scandinavian Journal of Work, Environment & Health·E Viikari-Juntura
Feb 1, 1984·The Journal of Hand Surgery : Journal of the British Society for Surgery of the Hand·A L Dellon
Jan 1, 1984·American Journal of Industrial Medicine·J Sällström, H Schmidt
Mar 1, 1995·Journal of Shoulder and Elbow Surgery·G M Rayan, C Jensen
Sep 1, 1994·The Clinical Journal of Pain·J L Quintner, M L Cohen
Apr 2, 1998·International Archives of Occupational and Environmental Health·J Greening, B Lynn
Jan 13, 1999·American Journal of Industrial Medicine·A ToomingasR Lundström
Aug 24, 1999·Scandinavian Journal of Rehabilitation Medicine·J NørregaardJ H Kristensen
Oct 6, 1999·Manual Therapy·T M Hall, R L Elvey
Jul 21, 2001·Regional Anesthesia and Pain Medicine·J L Quintner, G M Bove
Jan 1, 1996·The Australian Journal of Physiotherapy·Toby Hall, John Quintner
Sep 17, 2004·Acta Orthopaedica Scandinavica·Jørgen JepsenCarl-Göran Hagert

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Citations

May 1, 2010·BMC Musculoskeletal Disorders·Morten WaerstedKaj Bo Veiersted
Jan 9, 2008·Journal of Occupational Medicine and Toxicology·Jorgen R Jepsen, Gert Thomsen
Sep 8, 2011·Journal of Neurosciences in Rural Practice·Jørgen Riis Jepsen
Jan 16, 2014·Hand : Official Journal of the American Association for Hand Surgery·Elisabet Hagert
Apr 22, 2015·Journal of Occupational Medicine and Toxicology·Jørgen Riis Jepsen
Mar 8, 2007·Chiropractic & Osteopathy·Scott C Cuthbert, George J Goodheart
Mar 14, 2014·Plastic and Reconstructive Surgery·Elisabet Hagert, Carl-Göran Hagert

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