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A strong clinical diagnosis of cervical radiculopathy can be made with a thorough history and physical exam; however, findings are confirmed definitively by electrodiagnostic studies, including nerve conduction studies and needle electromyography. This activity describes the electrodiagnostic findings in both nerve conduction tests and needle electromyography in cervical radiculopathy and discusses the importance of an interprofessional team's role in managing care for treatment options. Objectives: Identify the indications for electrodiagnostic testing for cervical radiculopathy. Describe the nerve conduction study findings in a patient with cervical radiculopathy. Review the electromyographic findings in a patient with cervical radiculopathy. Outline the importance of communication among the interprofessional team to enhance the delivery of care and electrodiagnostic evaluation for patients with cervical radiculopathy. Access free multiple choice questions on this topic.

Cervical radiculopathy is most commonly precipitated by compression of a nerve root. Diagnosis is made by combining the patient’s symptoms, sensory and motor physical exam findings, and electrodiagnostic results. An electrodiagnostic evaluation may not be necessary if the clinical presentation is clear; however, electrodiagnostic studies confirm the diagnosis and determine prognosis.[1] The most common cause of compressive nerve radiculopathy is disc herniation; however, other compressive etiologies can cause nerve radiculopathy, including osteophyte, facet hypertrophy, and ligamentous hypertrophy. Noncompressive causes cannot be distinguished by electrodiagnostic testing form compressive ones unless they involve multiple myotomes and dermatomes. They include trauma, tumor, infections, demyelination, infarction, and post-radiation injury.

The risk of complications is low in electrodiagnostic studies.[9] A few complications that can occur include: Infection from the needle puncture Bleeding from the needle puncture Discomfort (if significant to the patient, the test should be terminated)

Cervical radiculopathy is a relatively common condition seen in the outpatient setting, particularly after trauma or a fall. Patients will present with symptoms of pain, numbness, or tingling. A standard workup includes imaging such as cervical x-rays, cervical computed tomographic (CT) scan, cervical magnetic resonance imaging (MRI), and an electrodiagnostic workup. MRI is the gold standard to evaluate herniated disc. It is also beneficial for identifying other pathologies like tumors, infections, and demyelinating disorders. A cervical CT scan is the study of choice for distinguishing an osteophyte's presence compressing the nerve root, especially if combined with myelography. Imaging solely is not sufficient in diagnosing cervical radiculopathy. Electrodiagnostic studies, along with a thorough history and physical exam, are important to diagnose a patient. The care of a patient with cervical radiculopathy involves several medical professionals, including physiatrists, neurologists, neurosurgeons, physical therapists, occupational therapists, social workers, and case managers. Cervical radiculopathy is initially managed conservatively with physical and occupational therapists' assistance, which typically resolves 75-90% of patients' symptoms.[12] Those who still feel pain can consider epidural steroid injections by pain management specialists, or surgical anterior or posterior discectomy by neurosurgeons. Studies have shown a communication gap between the patient's imaging results and actual clinical findings. Abnormal findings on cervical MRI can be shown without clinical symptoms, thus not needing an intervention.[13] Coordinated care and strong interprofessional communication between healthcare professionals and the patient are essential to maximizing outcomes.