Radiculopathy

Question 1

What is radiculopathy?

Answer 1

Conduction block in the axons of a spinal nerve or its roots, with impact on motor axons causing weakness and on sensory axons causing paraesthesia and or anaesthesia

Question 2

What is radicular pain rather than radiculopathy?

Answer 2

Radicular pain is derived from damage or irritation of the spinal nerve tissue, particularly the dorsal root ganglion

Question 3

Where do anterior and posterior roots of the spinal nerves unite?

Answer 3

Intervertebral foramina

Question 4

What can cause radiculopathy?

Answer 4

Intevertebral disc prolapse, degenerative disease of the spine, fracture, malignancy , infection

Question 5

Rupture of what causes an intervertebral disc prolapse?

Answer 5

annulus fibrosis and sequestration of disc material

Question 6

What will degenerative diseases of the spine lead to?

Answer 6

Neurofaminal or spinal canal stenosis

Question 7

Where in the spine is the most likely part to get degenerative changes?

Answer 7

C5/6 and C6/7

Question 8

What infections can cause radiculopathy?

Answer 8

Extradural abscesses, osteomyelitis, TB and Potts, Herpes zoster

Question 9

What are the clinical features of radiculopathy?

Answer 9

Sensory such as paraesthesia and numbness, motor features such as weakness, radicular pain

Question 10

What does radicular pain feel like?

Answer 10

Burning, deep, strap-like, narrow pain, usually not intermittent

Question 11

What should be checked for in examination of someone with suspected radiculopathy?

Answer 11

dermatomal and myotomal involvement, cauda equina syndrome, red flag symptoms and associated disorders

Question 12

What are some differential diagnosis for radiculopathy?

Answer 12

Pseudoradicular pain syndromes, referred pain, myofascial pain, thoracic outlet syndrome, greater trochanteric bursitis, iliotibial band syndrome, meralgia parathetica, piriformis syndrome

Question 13

What is myofascial pain?

Answer 13

hip musles can mimic pain from lumbar radiculopathy, shoulder girdle muscles can produce pain radiating into the upper extremity

Question 14

What is thoracic outlet syndrome?

Answer 14

Compression or irritation of the structures between the base of the neck and axial due to anatomical variations

Question 15

What is iliotibial band syndrome?

Answer 15

Excessive friction between the iliotibial band and the underlying bursa, tightness of the iliotibial tract, pain felt laterally, 2-3cm proximal to the knee

Question 16

What is meralgia paraesthetica?

Answer 16

Compression of the lateral cutaneous nerves of the thigh as it passes under the inguinal ligament, paraesthesia and or numbness in the anterolateral aspect of the thigh

Question 17

What is piriformis syndrome?

Answer 17

Anatomic variations in either the muscle or the sciatic nerve that can cause pain in the region of the sacroiliac joint or the sciatic notch

Question 18

What is the management of radiculopathy?

Answer 18

Treat cause and Usually analgesia, amitriptyline , Gaba antagonists and for muscle spasms- benzodiazepines, physiotherapy