Musculoskeletal mimics for lumbosacral radiculopathy. Part 2: Specific disorders.

IF 2.8 3区 医学 Q2 CLINICAL NEUROLOGY Muscle & Nerve Pub Date : 2024-11-05 DOI:10.1002/mus.28279
Shawn P Jorgensen, Anthony E Chiodo
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Abstract

Lumbosacral radiculopathy is a common disorder evaluated by the electrodiagnostic medicine (EDX) consultant. Making this task difficult is the abundance of radiculopathy mimics. Peripheral neurologic mimics are common, but musculoskeletal mimics are not rare and may be less familiar to many EDX consultants. Awareness of the most common musculoskeletal mimickers-particularly key historical and physical examination features that can distinguish them from radiculopathies-can lead to an accurate diagnosis for the patient and referring provider. Part 1 of this monograph covered theoretical issues surrounding why radiculopathy mimics occur. This second part reviews the most common musculoskeletal mimics, including facet arthropathy, myofascial pain syndrome, hip pathology, greater trochanteric pain syndrome, piriformis syndrome, sacroiliac joint dysfunction, hamstring pathology, iliotibial band syndrome, and plantar fasciitis. Diagnosis of these musculoskeletal mimickers is complicated by nonspecific physical examination and imaging findings, and diagnostic injections are frequently necessary to confirm the diagnosis. Treatment for most mimickers includes physical therapy, anti-inflammatory medications, guided injections, and other conservative measures, only rarely followed by surgical intervention. EDX consultants can efficiently incorporate a few high-yield maneuvers into their physical examination based on the location of the pain to provide answers to patients presenting with a musculoskeletal mimic of a lumbosacral radiculopathy.

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腰骶神经根病的肌肉骨骼模拟。第二部分:特定疾病。
腰骶神经根病是电诊断医学(EDX)顾问评估的常见疾病。使这项任务变得困难的是大量的根性病变模拟病例。外周神经病变的拟态很常见,但肌肉骨骼病变的拟态并不罕见,可能对许多 EDX 顾问来说不太熟悉。了解最常见的肌肉骨骼拟态,尤其是能够将其与根神经病区分开来的关键病史和体格检查特征,可以为患者和转诊医生提供准确的诊断。本专著的第一部分介绍了有关为什么会出现根状神经病拟态的理论问题。第二部分回顾了最常见的肌肉骨骼拟态,包括面关节病、肌筋膜疼痛综合征、髋关节病变、大转子疼痛综合征、梨状肌综合征、骶髂关节功能障碍、腿筋病变、髂胫束综合征和足底筋膜炎。非特异性的体格检查和影像学检查结果使这些肌肉骨骼疾病的诊断变得复杂,通常需要进行诊断性注射才能确诊。大多数模仿症的治疗包括物理治疗、抗炎药物、引导注射和其他保守措施,只有极少数情况下才进行手术干预。EDX 顾问可以根据疼痛的部位,在体格检查中有效地采用一些高效的手法,为出现腰骶椎根病的肌肉骨骼模拟症状的患者提供答案。
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来源期刊
Muscle & Nerve
Muscle & Nerve 医学-临床神经学
CiteScore
6.40
自引率
5.90%
发文量
287
审稿时长
3-6 weeks
期刊介绍: Muscle & Nerve is an international and interdisciplinary publication of original contributions, in both health and disease, concerning studies of the muscle, the neuromuscular junction, the peripheral motor, sensory and autonomic neurons, and the central nervous system where the behavior of the peripheral nervous system is clarified. Appearing monthly, Muscle & Nerve publishes clinical studies and clinically relevant research reports in the fields of anatomy, biochemistry, cell biology, electrophysiology and electrodiagnosis, epidemiology, genetics, immunology, pathology, pharmacology, physiology, toxicology, and virology. The Journal welcomes articles and reports on basic clinical electrophysiology and electrodiagnosis. We expedite some papers dealing with timely topics to keep up with the fast-moving pace of science, based on the referees'' recommendation.
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