Cervical Radiculopathy Assessment

Cervical radiculopathy is not that uncommon, and typically causes a shooting pain down a specific dermatome +/- associated myotomal weakness. Red flags would be weakness and trauma. As a rule of thumb, an outpatient MRI is indicated if there is no trauma, with a CT Scan in ED to exclude fractures if there is a history of trauma. Neurosurgery (in the public system) is usually only considered when there is pain *and* weakness. For initial pain management, see here. Most can be discharged with GP followup for titration of neuropathic pain medication and OP MRI.

Written in the negative:

C5 / C6:
No loss of sensation to lateral arm.
No weakness in shoulder abduction, external rotation, elbow flexion, forearm supination and pronation.
Biceps and brachioradialis reflexes normal.
C7:
No loss of sensation to lateral forearm/thumb/index finger.
No weakness on elbow and wrist extension, forearm pronation, and wrist flexion.
Triceps reflex normal.
C8:
No loss of sensation to medial forearm / hand / and fourth and fifth digits.
No weakness on finger extension, wrist extension, DIPJ flexion/extension, lumbricals, thumb flexion.
T1:
No numbness to anterior arm and medial forearm. Finger abduction and adduction normal.

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