Clinical localization · Core

Build a case for radiculopathy

Cervical & lumbosacral radiculopathy

A myotomal pattern across peripheral nerves supports root localization.

01SNAPs and preganglionic disease

  • Typical root lesions are proximal to the dorsal root ganglion, so distal SNAPs are often preserved.
  • Ganglion location, coexisting neuropathy and other exceptions prevent this rule from being diagnostic alone.

02Needle strategy

  • Seek consistent abnormalities in the same myotome across different peripheral nerves, with appropriate paraspinal sampling.
  • Myotomes overlap. Document uncertainty when multiroot disease or pain limits localization.

03Positive and negative findings

  • Purely sensory or non-motor-axonal root disease can have a normal needle examination.
  • Isolated paraspinal abnormalities require consideration of age, prior surgery and nonspecific changes.

Related nerves

Pause and explain

Explain in your own words: “EDX assesses physiological injury; imaging assesses structure. Both need clinical correlation.” Then think of a situation in which it could be misinterpreted.

Show a review prompt

Normal EMG does not exclude every radicular pain syndrome, and one abnormal muscle cannot precisely identify a root.

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References and further reading

Educational synthesis; independent neuromuscular specialist review is pending. Publication dates and compilation dates are distinct. This is an original teaching synthesis; consult the source for complete methods and criteria.