Clinical features and diagnosis of cervical radiculopathy
- Jenice Robinson, MD
Jenice Robinson, MD
- Assistant Professor Case Medical Center
- Neuroscience Institute
- Milind J Kothari, DO
Milind J Kothari, DO
- Professor of Neurology
- Penn State College of Medicine
Neck pain is extremely common and may arise from a number of causes. Cervical spondylosis and disc herniation were not thought to be causes of neck and arm pain until the 1940s, when ruptured cervical discs were first recognized as a cause of radicular symptoms in the arm in the absence of myelopathy [1,2]. In the early 20th century, symptoms now attributed to cervical radiculopathy were often ascribed to scalenus anticus compression of the brachial plexus and were treated by surgical section of the muscle.
Today, compressive cervical radiculopathy is recognized to be a common source of arm pain with or without sensory and motor dysfunction.
This topic will review the anatomy, pathophysiology, epidemiology, clinical evaluation, and diagnosis of cervical radiculopathy. The treatment of cervical radiculopathy is discussed separately. (See "Treatment and prognosis of cervical radiculopathy".)
The following is a brief review of the anatomy and bony architecture of the cervical spine.
Spinal column and joints — The cervical spinal column is comprised of seven vertebral bodies. The C1 vertebra (also known as the atlas) is a circular ring of bone without a body or a spinous process. The atlas connects the spine to the occipital bone of the skull superiorly, and articulates with the C2 vertebra (also known as the axis) inferiorly, without an intervening vertebral disc (figure 1).To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- Spinal column and joints
- Intervertebral foramina
- Nerve roots and dorsal root ganglia
- Cervical spondylosis
- Disc herniation
- Nondegenerative causes
- Danger signs
- Antecedent events
- Spurling maneuver
- Shoulder abduction relief test
- Imaging studies
- - MRI
- - CT myelography
- - Plain radiographs
- - Issues related to prior surgery
- Electrodiagnostic studies
- DIFFERENTIAL DIAGNOSIS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS