Table 6.
Combinations of Physical Examination Tests Chosen to Optimize Performance Characteristics for the Diagnosis of Level Specific Nerve Root Impingement on MRI*
| Physical Examination Test Combinations | Sens. (95% CI) |
Spec. (95% CI) |
LR+ (95% CI) |
LR− (95% CI) |
|---|---|---|---|---|
| L4 nerve root | ||||
| Ankle sensation or patellar reflex | 62 (36–82) |
95 (84–99) |
12 (3.0–51) |
0.41 (0.20–0.81) |
| Ankle sensation or patellar reflex or CFST | 62 (36–82) |
95 (84–99) |
13 (3.1–52) |
0.40 (0.20–0.81) |
| CFST or patellar reflex | 38 (18–64) |
95 (84–99) |
7.9 (1.7–36) |
0.65 (0.42–1.0) |
| L5 nerve root | ||||
| Achilles reflex or hip abduction | 61 (39–80) |
89 (75–96) |
5.5 (2.0–15) |
0.44 (0.24–0.79) |
*
Combinations with positive likelihood ratio point estimates ≥ 5.0
Sens. – Sensitivity (%)
Spec. – Specificity (%)
LR+ – Positive likelihood ratio
LR− – Negative likelihood ratio
CI – Confidence interval
FST – Femoral stretch test
CFST – Crossed femoral stretch test